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.

Mercy Hospitals East Communities (NPI 1427098169)

Field	Value
Entity Type	Organization
Organization	Mercy Hospitals East Communities
Address	615 S New Ballas Rd
City	Saint Louis
State	MO
ZIP	63141
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 8, 2006

Payer Source	Total Paid
Medicaid	$56.5M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and reports $56.5M in lifetime Medicaid revenue, making its Medicaid volume the effective primary payer exposure for analytical and contracting purposes. The absence of Medicare activity suggests the facility functions operationally as a Medicaid-focused provider within the state rather than as a balanced Medicare/Medicaid hospital.

Revenue concentration is high: the top three Medicaid codes (Y7506, 99285, 99284) together account for 49.1% of this provider's total Medicaid revenue, indicating that a small set of services—particularly emergency and related outpatient interventions—drive roughly half of Medicaid dollars. Individual top-code revenues are $9.2M for Y7506, $9.1M for 99285, and $6.7M for 99284, signaling tight dependence on these lines.

The code mix and descriptions point to a heavy emergency department and urgent care footprint: 99285 (53.1K claims, $9.1M) relates to high-acuity ED visits, 99284 (45K claims, $6.7M) to moderate-acuity ED visits, and 99283 (42.3K claims, $5.7M) to lower-acuity ED visits. High counts across 99285/99284/99283 and additional high-volume outpatient E/M codes (99212, 99211) indicate the hospital operates as a high-throughput acute care and ED center rather than being driven primarily by elective inpatient procedures.

Competitive standing in-state is dominant for several ED and lab services: 99285 ranks #1 of 596 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code) and 99284 ranks #4 of 953 (100th percentile; extreme outlier). Y7506 also ranks highly at #2 of 98 providers (99th percentile; notably above typical state volume for this code), which together signal the provider is a major hub for high-acuity emergency care in the state.

Laboratory and diagnostics are material secondary revenue drivers: 85025 shows 54.8K claims and $2.2M revenue (4.4% of Medicaid revenue) and 80053 shows 43.2K claims and $1.4M (2.8%). The proprietary PLA test 0202U (3.7K claims, $1.1M) ranks #1 of 22 providers in-state (100th percentile; notably above typical state volume), indicating investment in specific in-house or contracted molecular testing capacity.

Obstetric and fetal imaging services are notable components of the outpatient mix: 76816 (7.5K claims, $1.5M) and 76815 (3.1K claims, $1M) together reflect substantial prenatal ultrasound activity, and 59025 (4.5K claims, $878.7K) supports ongoing fetal heart rate monitoring volume. These codes rank in the upper percentiles statewide (94th–98th percentiles), suggesting the facility serves as a regional maternal–fetal services site for Medicaid patients.

There are targeted procedural volumes with concentrated leadership positions in niche services: 55175 (570 claims, $678.3K) ranks #1 of 3 providers in-state (100th percentile) and several echocardiography codes (93303, 93325, 93320, 93320) contribute meaningful revenue, reflecting hospital-based surgical and imaging capabilities that extend beyond ED throughput. While some of these procedure ranks are described as "typical, unremarkable volume," the presence of #1 ranks in small-n procedure categories indicates local clinical differentiation.

The provider has long operational tenure with an NPI enumerated on 2006-06-08 (~20 years ago), which supports interpretation of its current coding profile as the result of an established service mix rather than a very recent operational shift. Given the concentrated Medicaid revenue base and extreme outlier ED volumes, analysts should treat Medicaid contracting, ED capacity, and state-level utilization patterns as the primary levers for competitive and financial assessment of this entity.

Medicaid: Complete Services Breakdown

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

191 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
Y7506	N/A	37,990	$240	$9.2M
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.	53,060	$170	$9.1M
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.	45,030	$150	$6.7M
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.	42,350	$140	$5.7M
X4011	N/A	19,040	$200	$3.8M
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	54,810	$40	$2.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	25,010	$60	$1.6M
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	7,470	$200	$1.5M
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	43,160	$30	$1.4M
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	3,690	$290	$1.1M

Showing 1–10 of 191

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

Mercy Hospitals East Communities — 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

191 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
X4011	N/A	15	110	5,700	$340	$3.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	19	100	2,240	$80	$2.2M
Y7506	N/A	2	100	980	$250	$1.6M
X4003	N/A	22	70	1,480	$80	$1.1M
X4006	N/A	51	50	370	$780	$969.5K
D7999	N/A	3	20	190	$2,300	$708.3K
Y7507	N/A	28	50	270	$360	$594.9K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	58	90	1,850	$120	$384.1K
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.	1	600	140	$170	$384.1K
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…	44	110	2,100	$70	$364.3K

Showing 1–10 of 191

Related Providers

Other providers that share a Tax Identification Number (TIN) with Mercy Hospitals East Communities, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Hospital Jefferson	MO	General Acute Care Hospital	$0	$27.8M
Mercy Clinic East Communities	MO	Internal Medicine Physician	$0	$22.2M
Marissa Lewis	MO	Emergency Medicine Physician	$660.4K	$0
Christopher Hamm	MO	Internal Medicine Physician	$157K	$0
John Brunts	MO	Cardiovascular Disease Physician	$151.3K	$0
Suping Bao	MO	Nurse Practitioner	$135.1K	$0
Jeffrey Calvin	MO	Neurology Physician	$126.7K	$0
Patricia Schrader	MO	Adult Health Nurse Practitioner	$126.1K	$0
Kyeong Lee	MO	Neurology Physician	$104.2K	$0
Alfred Wang	IN	Emergency Medicine Physician	$98.4K	$0

Nearby Providers

Other providers in the same ZIP code as Mercy Hospitals East Communities, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bayada Home Health Care, Inc.	MO	Home Health Agency	$0	$41.2M
Excel Home Care, Inc.	MO	Home Health Agency	$0	$19.8M
Biotech X-ray Inc	MO	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	$5.1M	$6M
Western Anesthesiology Associates, Inc.	MO	Anesthesiology Physician	$0	$10.9M
Team Select Home Care Of Missouri, Inc.	MO	Nursing Care Agency	$0	$10.7M
Physician Groups Lc	MO	Multi-Specialty Clinic/Center	$0	$9.8M
Sensory Solutions, LLC	MO	Occupational Therapist	$0	$7.3M
Excel Home Care, Inc.	MO	Home Health Agency	$0	$6.2M
Independent Home Care, Inc	MO	Homemaker	$0	$5.7M
West County Radiological Group, Inc.	MO	Diagnostic Radiology Physician	$0	$5.4M

Mercy Hospitals East Communities — 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