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

Why is the Medicaid comparison limited to Delaware 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. Delaware (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. Francis Hospital Inc. (NPI 1275697088)

Field	Value
Entity Type	Organization
Organization	St. Francis Hospital Inc.
Address	701 N Clayton St 2nd Fl.
City	Wilmington
State	DE
ZIP	19805
Taxonomy	Family Medicine Physician
NPI Enumerated	December 19, 2006

Payer Source	Total Paid
Medicaid	$1.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

87 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	20,710	$30	$662.6K
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…	11,230	$50	$572.6K
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…	3,340	$40	$147.1K
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…	1,300	$60	$73.9K
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…	2,210	$20	$53K
99442	N/A	1,320	$40	$48.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	830	$50	$44.9K
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…	540	$80	$42.7K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	3,050	$10	$30.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	460	$60	$28.7K

Showing 1–10 of 87

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Delaware Distribution

St. Francis Hospital Inc. — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. Delaware median

87 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	6	10	960	$90	$285.9K
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…	28	80	940	$30	$277.8K
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…	48	500	1,130	$50	$235.1K
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…	23	50	1,070	$70	$226.6K
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	32	60	1,700	$50	$211.4K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	130	240	700	$60	$205.6K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	9	10	900	$50	$192.6K
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…	10	50	1,050	$60	$191.3K
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…	26	540	1,100	$40	$185.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	26	50	800	$70	$170.9K

Showing 1–10 of 87

Related Providers

Other providers that share a Tax Identification Number (TIN) with St. Francis Hospital Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Francis Hospital Inc.	DE	General Acute Care Hospital	$0	$43.2M
St Francis Hospital Inc	DE	Ambulance	$0	$3.8M
St Francis Hospital Inc	DE	Obstetrics & Gynecology Physician	$0	$711.4K
St. Francis Hospital Inc.	DE	Obstetrics & Gynecology Physician	$0	$488.7K
David Krasner	DE	Family Medicine Physician	$467.5K	$0
St. Francis Hospital Inc.	DE	Cardiovascular Disease Physician	$0	$463.8K
St Francis Hospital Inc.	DE	Family Medicine Physician	$0	$347.2K
Anthony Vasile	DE	Sleep Medicine (Internal Medicine) Physician	$163.4K	$68.2K
St. Francis Hospital Inc.	DE	Family Medicine Physician	$0	$199.2K
Joseph Pennington	DE	Clinical Cardiac Electrophysiology Physician	$145.7K	$0

Nearby Providers

Other providers in the same ZIP code as St. Francis Hospital Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bayada Home Health Care, Inc.	DE	Home Health Agency	$0	$56.8M
Always Best Care Of Delaware	DE	Home Health Agency	$0	$38.1M
State Of Delaware Dscyf	DE	Adolescent and Children Mental Health Clinic/Center	$0	$36.5M
Westside Family Healthcare, Inc.	DE	Federally Qualified Health Center (FQHC)	$0	$34.3M
Brandywine Counseling & Community Services, Inc.	DE	Adult Mental Health Clinic/Center	$170.8K	$23.9M
Connections Community Support Programs, Inc.	DE	Substance Use Disorder Rehabilitation Clinic/Center	$0	$16.4M
St Anthony's Community Center Inc	DE	Meals Provider	$0	$4.6M
Emergency Physician Associates Of Delaware PC	DE	Emergency Medicine Physician	$0	$4.2M
Horizon House Delaware Inc	DE	Case Management Agency	$0	$3.8M
Children's Dental Health Of Delaware, LLC	DE	Pediatric Dentistry	$0	$3.8M

St. Francis Hospital Inc. — Billing Profile & Reimbursement Data

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St. Francis Hospital 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

Related Providers

Nearby Providers

Frequently Asked Questions

References