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

Why is the Medicaid comparison limited to Kentucky 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. Kentucky (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. Claire Medical Center, Inc (NPI 1326009044)

Field	Value
Entity Type	Organization
Organization	St. Claire Medical Center, Inc
Address	316 W 2nd St
City	Morehead
State	KY
ZIP	40351
Taxonomy	Family Medicine Physician
NPI Enumerated	March 31, 2006

Payer Source	Total Paid
Medicaid	$3.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

66 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…	51,160	$30	$1.6M
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…	29,020	$50	$1.3M
0012A	N/A	2,280	$30	$59.3K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	1,830	$30	$53.1K
0011A	N/A	2,350	$20	$49.3K
0002A	N/A	640	$40	$23.1K
0013A	N/A	790	$30	$20.5K
M0247	Intravenous infusion, sotrovimab, includes infusion and post administration monitoring	50	$400	$19.6K
0001A	N/A	530	$40	$19.2K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	620	$30	$18.5K

Showing 1–10 of 66

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

St. Claire Medical Center, Inc — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

66 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	109	3,340	1,020	$30	$296K
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…	73	2,460	580	$40	$245K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	189	600	600	$40	$207.8K
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…	272	470	770	$20	$188.2K
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…	157	230	720	$60	$180.1K
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…	181	260	540	$70	$176.6K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	147	290	520	$30	$156.6K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	225	500	250	$60	$152.8K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	201	220	1,520	$10	$82K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	160	320	180	$70	$79.9K

Showing 1–10 of 66

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Claire Medical Center Inc	KY	General Acute Care Hospital	$0	$71.2M
St Claire Medical Center Inc.	KY	Emergency Medicine Physician	$0	$4M
St Claire Medical Center, Inc.,	KY	Cardiovascular Disease Physician	$0	$3.3M
St. Claire Medical Center, Inc	KY	Home Health Agency	$0	$3.1M
Tariq Mahmood	OK	Medical Oncology Physician	$253.8K	$17.8K
Eusebio Desuyo	ND	Pulmonary Disease Physician	$132.6K	$0
Matthew Shotwell	KY	Interventional Cardiology Physician	$109.3K	$0
Samuel Quaynor	GA	Neurology Physician	$93.9K	$14.6K
Steven Koenig	KY	Pulmonary Disease Physician	$104.5K	$0
Obiora Maludum	TN	Interventional Cardiology Physician	$104.3K	$0

Nearby Providers

Other providers in the same ZIP code as St. Claire Medical Center, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Edgewater Recovery Center LLC	KY	Substance Abuse Rehabilitation Facility	$0	$50.3M
D&s Residential Services, LP	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$33.6M
Gateway Area Development District	KY	Supports Brokerage Agency	$0	$20.8M
Lincare Inc.	KY	Durable Medical Equipment & Medical Supplies	$0	$3.4M
St Claire Medical Center, Inc	KY	Urgent Care Clinic/Center	$0	$3.3M
Rowan County Fiscal Court	KY	Land Ambulance	$384.7K	$767.5K
Christian Weigel	KY	Internal Medicine Physician	$105K	$0
Andrei Korossy	KY	Physical Therapist	$89.6K	$0
Lacinda Rishel	KY	Physician Assistant	$82.7K	$0
Alisha Perry	KY	Physician Assistant	$55.1K	$0

St. Claire Medical Center, Inc — Billing Profile & Reimbursement Data

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St. Claire Medical Center, 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