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

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

Ssm Health Care Group (NPI 1306589544)

Ssm Health Care Group is a internal medicine physician provider located in Saint Louis, Missouri. This profile covers 0 Medicare and 202 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	Ssm Health Care Group
Address	1225 South Grand Blvd
City	Saint Louis
State	MO
ZIP	63104
Taxonomy	Internal Medicine Physician
NPI Enumerated	April 15, 2022

Payer Source	Total Paid
Medicaid	$17.3M
Medicare	$0

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

202 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…	26,430	$100	$2.7M
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…	21,460	$80	$1.8M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	18,800	$80	$1.4M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	9,730	$120	$1.2M
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…	16,230	$50	$746.5K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	4,630	$150	$699.6K
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…	4,070	$160	$650.7K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	9,470	$60	$606K
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…	3,400	$160	$557.3K
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…	4,780	$110	$540.6K

Showing 1–10 of 202

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

Ssm Health Care Group — 13 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

202 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	72	600	140	$170	$384.1K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	58	950	120	$150	$288.2K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	36	1,260	220	$120	$242.4K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	19	30	110	$1,230	$229.7K
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	25	40	100	$330	$144.9K
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.	61	90	120	$250	$141.3K
95811	During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.	24	30	50	$650	$137.5K
00170	The provider performs anesthesia services for a patient undergoing an intraoral procedure, including biopsy.	45	100	50	$390	$131.8K
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	42	50	150	$440	$131.7K
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…	36	60	510	$70	$128.9K

Showing 1–10 of 202

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ssm-sluh Inc	MO	General Acute Care Hospital	$0	$20.6M
Niraj Pahlajani	TX	Radiation Oncology Physician	$1.4M	$0
Matthew Treaster	MO	Emergency Medicine Physician	$126.7K	$655.8K
Ahsan Usman	IL	Hospitalist Physician	$306.9K	$417.5K
George Hruza	MO	MOHS-Micrographic Surgery Physician	$713.1K	$0
Ramona Behshad	MO	MOHS-Micrographic Surgery Physician	$658.1K	$0
Paul Gruber	MO	Dermatology Physician	$586.1K	$0
Shamseldeen Mahmoud	MO	Neuroradiology Physician	$109.5K	$474K
Matthew Hrastich	MO	Diagnostic Radiology Physician	$134.1K	$399.7K
Beth Levy	MO	Cytopathology Physician	$532.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ssm Cardinal Glennon Children's Hospital	MO	Children's Hospital	$0	$52.6M
Levent Akduman	MO	Ophthalmology Physician	$3.1M	$1.4M
Affinia Healthcare	MO	Federally Qualified Health Center (FQHC)	$0	$4.2M
Southside Wellness Center Inc	MO	Personal Care Attendant	$0	$3.8M
Kristin Smith	MO	Dermatopathology Physician	$451.5K	$12.4K
Nicole Burkemper	MO	Dermatology Physician	$237K	$51.7K
M Yadira Hurley	MO	Dermatopathology Physician	$242K	$38.4K
Abdalla Hassan	MO	Interventional Cardiology Physician	$244K	$8.1K
Gillian Heinecke	MO	Dermatology Physician	$226.9K	$8K
Ece Akduman	MO	Diagnostic Radiology Physician	$59.6K	$169.5K

Ssm Health Care Group — Billing Profile & Reimbursement Data

Sign up for Ssm Health Care Group — Billing Profile & Reimbursement Data policy alerts

Ssm Health Care Group — Billing Profile & Reimbursement Data

Sign up for Ssm Health Care Group — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References