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

Why is the Medicaid comparison limited to Illinois 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. Illinois (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 Anthony Hospital (NPI 1194723999)

Saint Anthony Hospital is a general acute care hospital provider located in Chicago, Illinois. This profile covers 0 Medicare and 128 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 Anthony Hospital
Address	2875 W 19th St
City	Chicago
State	IL
ZIP	60623
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 14, 2005

Payer Source	Total Paid
Medicaid	$4.4M
Medicare	$0

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

128 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	28,150	$100	$2.8M
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…	17,420	$20	$313.5K
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	2,610	$110	$286.8K
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.	2,430	$50	$119.1K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	2,730	$30	$71K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	2,640	$20	$58K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	940	$60	$53.6K
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…	1,250	$40	$47.5K
0502F	No Summary found for this code	950	$40	$39.9K
97162	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	290	$110	$32.3K

Showing 1–10 of 128

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Illinois Distribution

Saint Anthony Hospital — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Illinois

Full comparison — all codes billed, vs. Illinois median

128 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	252	350	400	$70	$514.7K
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.	271	280	1,120	$30	$218.9K
87389	The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an…	101	250	450	$40	$185.7K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	20	1,220	540	$60	$179.4K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	114	360	600	$30	$165.1K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	114	360	630	$30	$165K
87661	The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique.	71	160	300	$20	$145.2K
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	28	110	200	$40	$111.1K
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.	57	350	390	$50	$107.7K
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…	37	1,210	1,070	$30	$102.1K

Showing 1–10 of 128

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lawndale Christian Health Center	IL	Federally Qualified Health Center (FQHC)	$0	$103.6M
Esperanza Health Centers	IL	Federally Qualified Health Center (FQHC)	$0	$16.5M
Pilsen-little Village Community Mental Health Center, Inc.	IL	Substance Use Disorder Rehabilitation Clinic/Center	$0	$15M
Access Community Health Network	IL	Federally Qualified Health Center (FQHC)	$0	$12.6M
Access Community Health Network	IL	Federally Qualified Health Center (FQHC)	$0	$5M
Manish Shukla	IL	Family Medicine Physician	$39.6K	$3.8M
Walter Perez	IL	Pediatrics Physician	$0	$3.8M
Access Community Health Network	IL	Federally Qualified Health Center (FQHC)	$0	$3.8M
Jaideep Atwal	IL	Dentist	$0	$3.5M
Cook County	IL	Primary Care Clinic/Center	$0	$3.3M

Saint Anthony Hospital — Billing Profile & Reimbursement Data

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Saint Anthony Hospital — 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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