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

Why is the Medicaid comparison limited to Arkansas 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. Arkansas (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 Bernards Clinics, Inc (NPI 1255632568)

St Bernards Clinics, Inc is a internal medicine physician provider located in Jonesboro, Arkansas. This profile covers 0 Medicare and 63 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 Bernards Clinics, Inc
Address	300 Carson St
City	Jonesboro
State	AR
ZIP	72401
Taxonomy	Internal Medicine Physician
NPI Enumerated	November 3, 2010

Payer Source	Total Paid
Medicaid	$1.9M
Medicare	$0

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

63 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	21,060	$20	$484.3K
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…	17,920	$20	$268.8K
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…	7,690	$30	$215.2K
90970	The provider manages for less than one full month all the daily services associated with the dialysis care of a patient who is 20 years old or older and has a condition known as end stage renal…	1,350	$140	$190.6K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	9,920	$20	$158.7K
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	2,690	$40	$118.3K
43235	The provider inserts an endoscope through the mouth and down into the esophagus, stomach, and duodenum for diagnostic purposes; the provider may collect specimens by brushing or washing.	900	$120	$105.5K
45378	The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush…	240	$220	$53.5K
90935	Hemodialysis is a procedure that involves drawing blood via an intra–arterial or intravenous catheter, then sieving it through a semi permeable membrane to remove the impurities and finally…	1,510	$30	$45.3K
99204	The provider sees a new 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 provider…	960	$40	$37.3K

Showing 1–10 of 63

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Arkansas Distribution

St Bernards Clinics, Inc — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arkansas

Full comparison — all codes billed, vs. Arkansas median

63 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	390	530	4,960	$70	$2.6M
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	62	80	300	$190	$134K
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.	139	200	1,600	$20	$129.3K
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…	126	1,520	550	$40	$128.7K
90970	The provider manages for less than one full month all the daily services associated with the dialysis care of a patient who is 20 years old or older and has a condition known as end stage renal…	3	20	420	$150	$120.9K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	11	260	430	$30	$93.3K
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…	58	1,740	550	$30	$88.8K
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	78	130	1,710	$10	$78.2K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	18	40	80	$190	$64.2K
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	6	20	590	$40	$63.2K

Showing 1–10 of 63

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mark Reed	TN	Gynecologic Oncology Physician	$2.3M	$0
Todd Tillmanns	TN	Gynecologic Oncology Physician	$1.1M	$0
Aamer Farooq	NJ	Hematology & Oncology Physician	$207.7K	$0
James Maxwell	AR	Nephrology Physician	$204K	$0
Corey Diamond	AR	Internal Medicine Physician	$188.6K	$0
Tammy Hawkins	AR	Psychiatric/Mental Health Nurse Practitioner	$126.5K	$0
Jeffrey Stidman	AR	Gastroenterology Physician	$116.6K	$0
John Thompson	AR	Pulmonary Disease Physician	$115.8K	$0
Don Howard	AR	Critical Care Medicine (Internal Medicine) Physician	$113.6K	$0
Rudolph Bowens	AR	Urology Physician	$100.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Focus, Inc	AR	Developmentally Disabled Services Day Training Agency	$0	$41.3M
St Bernards Hospital Inc	AR	General Acute Care Hospital	$0	$35.4M
Nea Therapy Providers, LLC	AR	Physical Therapist	$0	$26.9M
First Step Arkansas, LLC	AR	Early Intervention Provider Agency	$0	$23.8M
Communication Made Easy Inc	AR	Speech-Language Pathologist	$0	$17.8M
Baptist Memorial Hospital-jonesboro Inc	AR	General Acute Care Hospital	$0	$17M
The Logan Centers, Inc.	AR	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$16.5M
Arisa Health, Inc.	AR	Community/Behavioral Health Agency	$0	$15.6M
Kidsplace Learning Center Dba Kidspot	AR	Speech-Language Pathologist	$0	$14.1M
Miracle Kids Success Academy North	AR	Rehabilitation Clinic/Center	$0	$14M

St Bernards Clinics, Inc — Billing Profile & Reimbursement Data

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St Bernards Clinics, Inc — 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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