Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Indiana for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Indiana only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Indiana (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Saint Joseph Regional Medical Center- Plymouth Campus Inc (NPI 1174571129)

Saint Joseph Regional Medical Center- Plymouth Campus Inc is a general acute care hospital provider located in Plymouth, Indiana. This profile covers 0 Medicare and 99 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Saint Joseph Regional Medical Center- Plymouth Campus Inc
Address	1915 Lake Ave
City	Plymouth
State	IN
ZIP	46563
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 4, 2006

Payer Source	Total Paid
Medicaid	$6.5M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

99 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	13,710	$150	$2M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	490	$1,970	$957.4K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	5,720	$160	$926.5K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	3,390	$130	$430.5K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	2,470	$140	$353.8K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	2,250	$140	$305.7K
C9803	Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	5,290	$50	$280.3K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	1,420	$140	$193K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	2,600	$70	$168.8K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	15,020	$10	$90.1K

Showing 1–10 of 99

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Indiana providers billing the same CPT/HCPCS codes.

Claims Volume vs. Indiana Distribution

Saint Joseph Regional Medical Center- Plymouth Campus Inc — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. Indiana median

99 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	147	380	2,470	$100	$1.5M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	110	360	3,490	$110	$1.5M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	142	330	1,530	$100	$1.1M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	14	30	450	$1,270	$886.9K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	100	130	3,770	$60	$617.7K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	118	150	440	$100	$545.6K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	339	390	3,600	$50	$511.6K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	95	220	1,850	$30	$449.4K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	334	400	1,100	$40	$382.2K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	116	190	800	$40	$344.7K

Showing 1–10 of 99

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ascension Se Wisconsin Hospital, Inc	WI	General Acute Care Hospital	$0	$94.4M
Saint Joseph Regional Medical Center-south Bend Campus, Inc.	IN	General Acute Care Hospital	$0	$18.7M
Saint Joseph Regional Medical Center, Inc.	IN	Pulmonary Disease Physician	$0	$5.5M
Saint Joseph Regional Medical Center-south Bend Campus, Inc.	IN	Family Medicine Physician	$0	$4.8M
Zulfiqar Mirza	IN	Cardiovascular Disease Physician	$392.2K	$0
Douglas Liepert	IN	Sleep Medicine (Otolaryngology) Physician	$392K	$0
Eric Kim	CA	Neurology Physician	$300.8K	$0
Marcos Cruz	PR	Neurology Physician	$142.7K	$63.2K
Greg Schaublin	FL	Neurology Physician	$202.8K	$0
Vivian Hoang	TX	Neurology Physician	$191.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hhc Indiana Inc.	IN	Psychiatric Hospital	$0	$15.3M
Dental Center Of Plymouth LLC	IN	Dentist	$0	$3M
South Bend Psychiatry LLC	IN	Psychiatry Physician	$0	$2.8M
Muhammad Hussain	IN	Medical Oncology Physician	$932.8K	$0
Adam Perlmutter	IN	Urology Physician	$156.4K	$0
John Lafree	IN	Physical Therapist	$63K	$0
Brian Piazza	IN	Surgery Physician	$28.5K	$0
Melinda Halupa	IN	Nurse Practitioner	$22.5K	$0

Saint Joseph Regional Medical Center- Plymouth Campus Inc — Billing Profile & Reimbursement Data

Sign up for Saint Joseph Regional Medical Center- Plymouth Campus Inc — Billing Profile & Reimbursement Data policy alerts

Saint Joseph Regional Medical Center- Plymouth Campus Inc — Billing Profile & Reimbursement Data

Sign up for Saint Joseph Regional Medical Center- Plymouth Campus Inc — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References