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.

St Anthonys Physician Organization Hospitalist Services, L.c. (NPI 1407216336)

St Anthonys Physician Organization Hospitalist Services, L.c. is a hospitalist physician provider located in Saint Louis, Missouri. This profile covers 0 Medicare and 16 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 Anthonys Physician Organization Hospitalist Services, L.c.
Address	10010 Kennerly Rd
City	Saint Louis
State	MO
ZIP	63128
Taxonomy	Hospitalist Physician
NPI Enumerated	March 4, 2016

Payer Source	Total Paid
Medicaid	$4.2M
Medicare	$0

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	23,750	$50	$1.3M
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	10,800	$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…	21,240	$40	$870.7K
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…	9,590	$70	$633.1K
90870	The provider applies an electric current to the patient's brain for the purpose of producing a seizure or series of seizures to alleviate symptoms of various mental disorders.	310	$150	$45.1K
99255	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a high level of medical decision making or the provider spends at…	190	$120	$23.1K
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…	290	$80	$21.8K
99254	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider spends…	120	$100	$12.8K
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…	120	$60	$7.5K
99220	N/A	50	$90	$4.8K

Showing 1–10 of 16

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

St Anthonys Physician Organization Hospitalist Services, L.c. — 4 of 16 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

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	25	590	260	$40	$120.5K
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…	3	400	160	$50	$78.8K
90870	The provider applies an electric current to the patient's brain for the purpose of producing a seizure or series of seizures to alleviate symptoms of various mental disorders.	7	10	310	$90	$76K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	2	260	100	$100	$67.7K
99255	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a high level of medical decision making or the provider spends at…	15	30	190	$130	$57.2K
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…	2	190	100	$60	$48.7K
99254	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider spends…	21	50	100	$140	$41K
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…	73	260	90	$70	$26.2K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	104	260	130	$20	$23K
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…	148	440	60	$50	$18.6K

Showing 1–10 of 16

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laishang Zhang	MO	Psychiatry Physician	$221.3K	$6.5K
Kimberly Harsy	MO	Family Nurse Practitioner	$164.1K	$22.7K
Bamidele Ganiyu	MO	Psychiatric/Mental Health Nurse Practitioner	$174.3K	$0
Cullen Hoos	IL	Hospitalist Physician	$104.6K	$20.6K
Richard Head	MO	Neurology Physician	$92K	$0
Eduardo Garcia-ferrer	MO	Psychiatry Physician	$59.9K	$10.8K
Zachary Oman	NE	Interventional Cardiology Physician	$63.3K	$0
Anne Longtine	ME	Internal Medicine Physician	$60.2K	$0
Shoaib Khan	AR	Internal Medicine Physician	$50.9K	$0
James Green	MO	Nurse Practitioner	$48.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Hospital South	MO	General Acute Care Hospital	$0	$22M
Nabil Tauk	MO	Nephrology Physician	$315K	$969.7K
Navin Tekwani	MO	Ophthalmology Physician	$533.8K	$0
Lawrence Wang	MO	Dermatology Physician	$318.8K	$0
Iqbal Amin	MO	Geriatric Medicine (Internal Medicine) Physician	$309.8K	$0
Miguel Gelman	MO	Diagnostic Radiology Physician	$168.3K	$140.8K
K. Thampy	MO	Endocrinology, Diabetes & Metabolism Physician	$307.6K	$0
Danish Jabbar	MO	Internal Medicine Physician	$295.6K	$0
Jeffrey Judd	MO	Diagnostic Radiology Physician	$244.2K	$30.2K
Old Tesson Surgery Center, L.P.	MO	Ambulatory Surgical Clinic/Center	$273.5K	$0

St Anthonys Physician Organization Hospitalist Services, L.c. — Billing Profile & Reimbursement Data

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St Anthonys Physician Organization Hospitalist Services, L.c. — 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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