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 Pennsylvania for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Pennsylvania 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. Pennsylvania (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.

St. Joseph Medical Group (NPI 1184754657)

St. Joseph Medical Group is a family medicine physician provider located in Reading, Pennsylvania. This profile covers 0 Medicare and 95 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	St. Joseph Medical Group
Address	2500 Bernville Road
City	Reading
State	PA
ZIP	19605
Taxonomy	Family Medicine Physician
NPI Enumerated	March 6, 2007

Payer Source	Total Paid
Medicaid	$7.2M
Medicare	$0

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

95 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	28,790	$90	$2.5M
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	31,430	$70	$2.1M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	3,580	$80	$275.4K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	10,370	$20	$248.8K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	3,260	$70	$218.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2,860	$80	$214.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,340	$80	$196.6K
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	1,710	$80	$140K
95886	The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more…	950	$140	$130.5K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	1,160	$110	$127.9K

Showing 1–10 of 95

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

St. Joseph Medical Group — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

95 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	775	980	310	$50	$136.6K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	45	820	230	$80	$71.7K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	29	8,160	210	$60	$68.4K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	37	660	180	$70	$63.7K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	48	8,870	240	$40	$56.1K
99218	N/A	4	10	40	$500	$53.4K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	283	610	90	$60	$50.1K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	136	260	40	$200	$49.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	47	870	160	$70	$48.2K
T1001	Nursing assessment / evaluation	55	70	90	$120	$46.5K

Showing 1–10 of 95

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pejman Rohani	MD	Vascular Surgery Physician	$1M	$0
Hammad Raza	PA	Hospitalist Physician	$238.3K	$60.1K
Gregory Tocks	PA	Adult Reconstructive Orthopaedic Surgery Physician	$286.9K	$1.2K
Nader Rahmanian	PA	Geriatric Medicine (Internal Medicine) Physician	$259K	$0
Wayne Pinover	PA	Radiation Oncology Physician	$255.8K	$0
Erin Moore	FL	Vascular Surgery Physician	$207K	$0
Michael Bradley	PA	Family Medicine Physician	$179K	$0
Colin Heinle	PA	Orthopaedic Surgery Physician	$133.3K	$25.1K
Joshua Karp	PA	Hospitalist Physician	$137.2K	$0
Rijesh Shrestha	WA	Internal Medicine Physician	$129.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Joseph Regional Health Network	PA	General Acute Care Hospital	$0	$27.8M
Steven Chmielewski	PA	Diagnostic Radiology Physician	$282.2K	$0
Christopher Testa	PA	Diagnostic Radiology Physician	$278.7K	$0
Atif Qureshi	PA	Internal Medicine Physician	$115.6K	$0
Peter Christ	PA	Clinical Pathology/Laboratory Medicine Physician	$109.5K	$0
Warqaa Majeed	PA	Neurology Physician	$105.2K	$0
Harold Einsig	PA	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$75.2K	$0
Jie Zhu	PA	Interventional Pain Medicine Physician	$56.1K	$0
Michelle Reed	PA	Family Nurse Practitioner	$51.2K	$0
Karen Gurski	PA	Specialist	$33.6K	$0

St. Joseph Medical Group — Billing Profile & Reimbursement Data

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St. Joseph Medical Group — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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