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.

Saint Joseph Health System, Inc (NPI 1437150984)

Key Findings

Field	Value
Entity Type	Organization
Organization	Saint Joseph Health System, Inc
Address	1 Saint Joseph Dr
City	Lexington
State	KY
ZIP	40504
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 9, 2005

Payer Source	Total Paid
Medicaid	$85.5M
Medicare	$0

This provider is effectively a single-payer Medicaid hospital: there is no Medicare billing on file while total reported Medicaid revenue is $85.5M. The absence of Medicare activity combined with material Medicaid billing suggests the facility’s inpatient and outpatient economics are concentrated on Medicaid-covered patients rather than a mixed Medicare/Medicaid payer mix.

Revenue concentration is highly focused in emergency department evaluation-and-management codes: the precomputed top-3 Medicaid codes account for 59.0% of this provider’s total Medicaid revenue, driven by 99283 ($18M, 26.5%), 99284 ($15.3M, 22.5%), and 99285 ($6.7M, 9.9%). That degree of concentration signals that ED throughput and related acute-care services are the primary revenue drivers for the organization.

The raw ED volumes support an ED-centric operating model: 99283 has 73.6K claims, 99284 has 42K claims, and 99285 has 16.6K claims, showing large overall ED visit counts with a mix of low, moderate, and high medical-decision-making encounters. The presence of all three E/M severity levels in the top revenue slots indicates the hospital treats a broad acuity range, from straightforward to high-acuity emergency care.

Competitive standing by code is mixed but generally strong for several ED services: 99283 ranks #10 of 284 providers in-state (97th percentile) and is described as having typical, unremarkable volume; 99284 ranks #31 of 282 (89th percentile) and 99285 ranks #48 of 239 (80th percentile), both labeled typical, unremarkable volumes. These rankings place the facility in the upper state percentiles for key ED codes, consistent with a busy emergency department even if some descriptions label the volumes as typical.

One statistical outlier within the dataset is 99282 (21.4K claims, $2.9M revenue, 4.3% of Medicaid revenue), which ranks #7 of 158 providers in-state (96th percentile) and is explicitly labeled as notably above typical state volume. That elevated standing for a lower-acuity ED code suggests above-average use of brief ED E/M services relative to peers and may reflect operational throughput or triage/observation patterns.

Imaging and procedural support lines contribute meaningful secondary revenue, consistent with an acute-care hospital platform: CT abdomen/pelvis without contrast 74176 ($3.7M, 5.4%), CT with contrast 74177 ($3.3M, 4.8%), and CT head 70450 ($1.8M, 2.6%) are all in the top-25 Medicaid codes, and cardiac imaging/catheterization codes such as 93458 ($1.2M, 1.8%) and echo 93306 ($1.2M, 1.8%) appear as material contributors. State ranks for these imaging and cardiology codes are generally in mid-to-high percentiles (for example, 74176 is 87th percentile, 74177 is 69th percentile), which supports a capability profile that includes advanced diagnostic and interventional services.

Operational and payer-risk observation: heavy reliance on Medicaid ($85.5M) with no Medicare billing on file concentrates reimbursement exposure to Medicaid policy and rate changes. Given that the top three codes account for 59.0% of Medicaid revenue and are ED-driven, shifts in Medicaid emergency care reimbursement or utilization patterns could disproportionately affect this provider’s revenue.

The provider is an established entity with NPI enumeration dating to 2005-08-09 (~21 years ago), indicating long-standing participation in state payer networks; that tenure, combined with the facility’s high state-percentile rankings on several ED and imaging codes, suggests an entrenched role in the local acute-care market focused on emergency and diagnostic services.

Medicaid: Complete Services Breakdown

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

390 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.	73,640	$250	$18M
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.	41,980	$370	$15.3M
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.	16,630	$410	$6.7M
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	7,290	$500	$3.7M
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.	5,610	$590	$3.3M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	21,410	$140	$2.9M
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	7,920	$220	$1.8M
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…	28,690	$50	$1.5M
G0378	Hospital observation service, per hour	5,050	$250	$1.3M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	32,030	$40	$1.3M

Showing 1–10 of 390

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

Saint Joseph Health System, Inc — 3 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

390 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	186	310	830	$120	$3.7M
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.	31	280	7,150	$150	$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.	48	240	4,710	$150	$2.6M
G0483	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	60	70	1,650	$100	$2M
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.	10	280	5,700	$120	$2M
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.	56	180	1,870	$280	$1.5M
G0378	Hospital observation service, per hour	29	90	2,770	$190	$1.3M
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…	22	30	2,320	$290	$1.2M
C1776	Joint device (implantable)	3	20	130	$2,890	$1.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	35	80	7,740	$30	$1.1M

Showing 1–10 of 390

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saint Joseph Health System, Inc	KY	Rural Acute Care Hospital	$0	$83.7M
Saint Joseph Health System, Inc	KY	General Acute Care Hospital	$0	$67.4M
Kentuckyone Health Medical Group, Inc.	KY	Family Medicine Physician	$0	$38.9M
Saint Joseph Health System, Inc	KY	General Acute Care Hospital	$0	$37.2M
Saint Joseph Health System, Inc	KY	Critical Access Hospital	$0	$29.8M
Robert Lavey	KY	Radiation Oncology Physician	$384.3K	$0
Emmanuel Nidhiry	KY	Medical Oncology Physician	$347.6K	$0
Nicola Jabbour	KY	Hematology & Oncology Physician	$195.8K	$0
Aman Khurana	IL	Internal Medicine Physician	$152.8K	$41.4K
Muhammad Niazi	KY	Hematology & Oncology Physician	$91.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Maxim Healthcare Services Inc.	KY	Home Health Agency	$0	$20.5M
Hospice Of The Bluegrass, Inc	KY	Community Based Hospice Care Agency	$0	$17.9M
Columbus Medical Services, LLC	KY	Case Management Agency	$0	$12.1M
Hospice Of The Bluegrass, Inc	KY	Community Based Hospice Care Agency	$0	$9.3M
Horn And Associates In Rehabilitation PLLC	KY	Rehabilitation Practitioner	$0	$8.3M
New Lexington Clinic, Psc	KY	Multi-Specialty Clinic/Center	$0	$8.2M
Serenity Keepers	KY	Adult Mental Health Clinic/Center	$0	$7.9M
Lexington Surgery Center Ltd	KY	Ambulatory Surgical Clinic/Center	$1.3M	$5.4M
Cogent Healthcare Of Kentucky, Psc	KY	Internal Medicine Physician	$0	$4.4M
Encompass Health Rehabilitation Hospital Of Cardinal Hill, LLC	KY	Rehabilitation Hospital	$0	$4.2M

Saint Joseph Health System, Inc — Billing Profile & Reimbursement Data

Sign up for Saint Joseph Health System, Inc — Billing Profile & Reimbursement Data policy alerts

Saint Joseph Health System, Inc — Billing Profile & Reimbursement Data

Sign up for Saint Joseph Health System, Inc — Billing Profile & Reimbursement Data policy alerts

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