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

Why is the Medicaid comparison limited to Tennessee 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. Tennessee (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 Francis Physician Network, LLC (NPI 1295258002)

Saint Francis Physician Network, LLC is a family medicine physician provider located in Covington, Tennessee. This profile covers 0 Medicare and 89 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 Francis Physician Network, LLC
Address	4501 Mueller Brass Rd
City	Covington
State	TN
ZIP	38019
Taxonomy	Family Medicine Physician
NPI Enumerated	July 24, 2017

Payer Source	Total Paid
Medicaid	$3.3M
Medicare	$0

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

89 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…	40,570	$30	$1.3M
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…	24,590	$30	$639.2K
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…	34,910	$10	$384K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	9,500	$30	$237.4K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	38,110	$1	$114.3K
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	70	$1,270	$93.9K
76830	The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.	890	$80	$66.6K
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	1,500	$40	$54.1K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	2,090	$20	$46K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	590	$60	$36.3K

Showing 1–10 of 89

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Saint Francis Physician Network, LLC — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

89 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	46	80	100	$1,260	$405.3K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	72	150	390	$60	$220.9K
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.	152	170	340	$190	$206.8K
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…	72	3,760	610	$40	$202.3K
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…	176	4,050	620	$30	$183.9K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	15	240	510	$50	$125.9K
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…	209	1,080	120	$80	$90.7K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	78	200	130	$60	$86.5K
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	66	150	210	$70	$85.6K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	92	260	300	$30	$84.6K

Showing 1–10 of 89

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pranab Das	TN	Cardiovascular Disease Physician	$490.1K	$131.6K
Syed Shirazee	TN	Pulmonary Disease Physician	$249.4K	$146.4K
Muhammad Janjua	TN	Interventional Cardiology Physician	$377.4K	$0
Dan Phan	AR	Anatomic Pathology & Clinical Pathology Physician	$278.1K	$0
Forrest Ward	TN	Internal Medicine Physician	$202.1K	$3.3K
Said Elias	TN	Internal Medicine Physician	$149.2K	$46.2K
Nurlela Gouveia	TN	Geriatric Medicine (Internal Medicine) Physician	$172.7K	$4.6K
Joseph Okolo	TN	Cardiovascular Disease Physician	$166.8K	$0
Quan Chen	TN	Diagnostic Radiology Physician	$146.2K	$0
Farees Farooq	TN	Gastroenterology Physician	$140.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Professional Care Services Of West Tn, Inc.	TN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$33.2M
Personal Care Services Midsouth, LLC	TN	In Home Supportive Care Agency	$0	$18M
Baptist Memorial Hospital-tipton	TN	General Acute Care Hospital	$0	$13.9M
Karen Martin	TN	Family Nurse Practitioner	$97.9K	$0
James Martin	TN	Family Medicine Physician	$85.7K	$0
Lusia Filetti	TN	Obstetrics & Gynecology Physician	$7.5K	$0

Saint Francis Physician Network, LLC — Billing Profile & Reimbursement Data

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Saint Francis Physician Network, LLC — 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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