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

Why is the Medicaid comparison limited to Indiana 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. Indiana (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. Mary's Health, Inc. (NPI 1427082957)

Key Findings

Field	Value
Entity Type	Organization
Organization	St. Mary's Health, Inc.
Address	3700 Washington Ave
City	Evansville
State	IN
ZIP	47750
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 10, 2006

Payer Source	Total Paid
Medicaid	$34.6M
Medicare	$0

This provider has no Medicare billing on file and reports $34.6M in lifetime Medicaid revenue, making its public claims footprint effectively single‑payer in scale and heavily dependent on Medicaid receipts. Analysts should treat Medicaid as the primary payer when modeling revenue risk or contracting exposure for this entity.

Revenue is highly concentrated in emergency department evaluation-and-management services: the precomputed top three Medicaid codes account for 48.6% of the provider's total Medicaid revenue, driven by 99283 ($7.2M, 22.6%), 99284 ($5.3M, 16.5%), and 99285 ($3.1M, 9.5%). This concentration indicates that nearly half of Medicaid dollars are tied to varying levels of ED E/M encounters rather than elective inpatient or specialist procedural revenue.

The code mix—large volumes of 99283/99284/99285 plus significant claims for 93005, 71045/71046, 74177, and multiple infusion codes (96361, 96374, 96375)—is consistent with an operational profile of a general acute care hospital with a high-throughput emergency department, in-house imaging, and active IV/infusion services supporting acute presentations. These lines point to ED-driven throughput as the core service line supporting Medicaid revenue.

On competitive standing for ED services, the provider posts high in-state percentiles but is described as typical in volume: 99283 ranks #21 of 364 (94th percentile), 99284 ranks #23 of 382 (94th percentile), and 99285 ranks #32 of 325 (90th percentile). In plain terms, the hospital is a strong regional ED participant with above-median Medicaid ED volumes, but it is not portrayed in the data as uniquely dominant for those codes relative to other Indiana providers.

The provider is a clear regional hub for diagnostic respiratory and drug testing, with extreme outlier volumes for multiple lab codes: 87502 ranks #2 of 159 (99th percentile, extreme outlier), 87635 ranks #3 of 246 (99th percentile, extreme outlier), 80306 ranks #1 of 40 (100th percentile, extreme outlier), and 87634 ranks #1 of 52 (100th percentile, extreme outlier). These rankings indicate extraordinarily high Medicaid testing throughput for influenza, SARS–CoV‑2, presumptive drug screens, and RSV compared with in-state peers.

Several infusion, monitoring, and supportive-care codes are notably above typical state volumes, reinforcing the acute/ED focus: 96361 (17.8K claims, $1.8M, 5.6%) ranks #5 of 107 (96th percentile, notably above typical), 94761 (24.7K claims, $1.4M, 4.5%) ranks #2 of 19 (94th percentile, notably above typical), and 96374/96375 also appear in high-percentile positions. Together these indicate sustained, high-frequency administration and monitoring services consistent with a busy emergency and observation environment.

High-volume basic laboratory and imaging throughput supports the ED profile: 80053 (61.1K claims, $366.5K, 1.1%) ranks #11 of 211 (95th percentile, notably above typical) while chest x‑ray and CT codes (71045, 71046, 70450, 74177) and pathology 88305 appear across the top-25 list. This pattern suggests in-house diagnostics and imaging capacity that underpin the provider's Medicaid revenue mix rather than reliance on outsourced or ambulatory specialty services.

The provider has an NPI enumeration date of 2006-07-10 (~20 years ago), indicating roughly two decades of enrollment in federal directories; combined with its Medicaid revenue concentration and the service mix above, this tenure is consistent with an established community hospital offering long-standing ED and diagnostic services to Medicaid populations.

Medicaid: Complete Services Breakdown

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

168 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	51,040	$140	$7.2M
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.	53,040	$100	$5.3M
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.	30,030	$100	$3.1M
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	31,680	$60	$1.9M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	17,840	$100	$1.8M
94761	The provider takes multiple measurements of the patient’s oxygen saturation using a sensor on the ear or finger.	24,680	$60	$1.4M
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	12,390	$110	$1.3M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	29,300	$40	$1.3M
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	2,050	$540	$1.1M
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	15,240	$70	$1M

Showing 1–10 of 168

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Indiana Distribution

St. Mary's Health, Inc. — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. Indiana median

168 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	23	380	2,470	$100	$1.5M
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.	21	360	3,490	$110	$1.5M
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.	32	330	1,530	$100	$1.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	43	100	2,210	$70	$926K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	28	30	450	$1,270	$886.9K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	9	130	3,770	$60	$617.7K
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…	426	580	710	$60	$582.9K
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.	35	150	440	$100	$545.6K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	42	220	1,850	$30	$449.4K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	30	140	430	$220	$413.2K

Showing 1–10 of 168

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Mary's Health, Inc.	IN	Ambulance	$792K	$2.3M
Douglas Debenham	IN	Radiation Oncology Physician	$1.8M	$0
Darin Serletic	IN	Podiatrist	$895.5K	$0
Charles Lackey	IN	Diagnostic Radiology Physician	$683.9K	$0
Vijay Bhasin	IN	Nephrology Physician	$539.9K	$0
Anthony Voelkel	IN	Interventional Cardiology Physician	$248.8K	$0
Anthony Stephens	IN	Hematology & Oncology Physician	$227.9K	$0
Shelene Ruggio	IN	Internal Medicine Physician	$217.9K	$0
Brandon Wynn	IN	Diagnostic Radiology Physician	$168.6K	$44.4K
Michael Titzer	IN	Hematology & Oncology Physician	$186.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Mary's Medical Group, LLC	IN	Family Medicine Physician	$0	$31.1M
Lori Lynch	IN	Anatomic Pathology & Clinical Pathology Physician	$353.6K	$0
Robert Franklin	IN	Anatomic Pathology & Clinical Pathology Physician	$85.9K	$0
Robert Vogt	IN	Vascular & Interventional Radiology Physician	$67K	$0
Anthony Funke	IN	Anesthesiology Physician	$35.8K	$0
Scott Hardigree	IN	Anesthesiology Physician	$30.2K	$0
Aaron Gries	IN	Anesthesiology Physician	$28.5K	$0
Tommy Symreng	IN	Anesthesiology Physician	$24.8K	$0
Hongyu Yang	IN	Anatomic Pathology & Clinical Pathology Physician	$21.6K	$0
Randy Lance	IN	Anesthesiology Physician	$17.5K	$0

St. Mary's Health, Inc. — Billing Profile & Reimbursement Data

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St. Mary's Health, Inc. — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References