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 1447457775)

Field	Value
Entity Type	Organization
Organization	Saint Joseph Health System, Inc
Address	150 N Eagle Creek Dr
City	Lexington
State	KY
ZIP	40509
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 29, 2007

Payer Source	Total Paid
Medicaid	$67.4M
Medicare	$0

Key Findings

SAINT JOSEPH HEALTH SYSTEM, INC is an established General Acute Care Hospital with an NPI enumerated 2007-06-29 (~19 years ago). Its billing footprint is almost entirely on Medicaid: lifetime Medicaid revenue is $67.4M and there is no Medicare billing on file, making the provider effectively single-payer (Medicaid) in the available claims data.

Revenue is highly concentrated in emergency department evaluation-and-management services: the precomputed top-three Medicaid codes (99284, 99283, 99285) account for 51.7% of this provider's total Medicaid revenue. Those three codes individually represent $11.4M (22.8%) for 99284, $9.6M (19.2%) for 99283, and $4.9M (9.7%) for 99285, indicating the ED is the primary revenue driver.

Claim volumes reinforce that this provider operates a high-throughput ED: 99284 shows 31.4K claims, 99283 shows 38.8K claims, and 99285 shows 11.5K claims, and observation care is also used (G0378: 9.8K claims, $1.4M). The mix of high-count E/M codes plus substantial observation hours is consistent with an acute-care hospital that routes a steady stream of unscheduled patients through ED and short-stay pathways.

Ancillary imaging and diagnostic services meaningfully support the ED and outpatient work: 74177 (CT abdomen/pelvis w/ contrast) generated $3.7M (7.3%), 74176 (CT without contrast) $1.6M (3.3%), and 70450 (CT head w/o contrast) $1M (2.1%). High-volume basic labs and panels (80053: 47.5K claims, $570.3K) and specialized PLA testing (0202U: $829.7K) further suggest in-house radiology and lab capacity that sustains acute and outpatient workflows.

There is notable activity in infusion, chemotherapy, and rehabilitative services alongside ED care: chemotherapy/infusion codes such as 96413 ($761.4K) and 96365 ($745K) and therapeutic exercise 97110 ($1.2M, 16.7K claims) indicate the hospital also supports oncology/infusion and PT services. These service lines diversify revenue beyond pure emergency throughput and point to mixed inpatient/outpatient clinical capabilities.

Several codes show the provider is competitive in-state but not overwhelmingly dominant: 99283 ranks #28 of 284 providers (90th percentile), 99284 ranks #43 of 282 (85th percentile), and 99285 ranks #64 of 239 (74th percentile), which together indicate above-average ED volume relative to peers but not statewide dominance. Conversely, the provider ranks #8 of 77 (91st percentile) on G0463 and #45 of 776 (94th percentile) on 97110, highlighting stronger relative positioning in hospital outpatient clinic visits and therapeutic exercise services.

A few procedural and lab items stand out as local differentiators: 58662 (laparoscopic destruction/excision of ovarian/peritoneal lesions) is $648.3K and ranks #1 of 4 providers (100th percentile), suggesting the hospital is a primary in-state provider for that specific gynecologic procedure. High volumes of drug testing (80307: 24K claims, $1M; G0480: 11.8K claims, $625K) and 93005 EKGs (19.5K claims, $955.1K) further underscore robust ED-related ancillary throughput.

The absence of Medicare billing combined with $67.4M in Medicaid revenue implies payer-concentration risk: the provider’s financial exposure and operational priorities will be closely tied to state Medicaid policy and reimbursement levels. Analysts should treat this profile as a Medicaid-centric operation with substantial ED-driven volumes, significant imaging/lab capacity, and complementary outpatient and infusion services rather than a mixed Medicare/Medicaid hospital model.

Medicaid: Complete Services Breakdown

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

358 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	31,360	$360	$11.4M
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.	38,800	$250	$9.6M
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.	11,550	$420	$4.9M
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.	6,770	$540	$3.7M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	43,100	$40	$1.9M
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.	13,190	$140	$1.8M
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.	3,500	$460	$1.6M
G0378	Hospital observation service, per hour	9,850	$140	$1.4M
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	16,660	$70	$1.2M
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	23,960	$40	$1M

Showing 1–10 of 358

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 — 1 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

358 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.	132	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.	43	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.	64	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…	50	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.	28	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.	50	180	1,870	$280	$1.5M
G0378	Hospital observation service, per hour	15	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…	11	30	2,320	$290	$1.2M
C1776	Joint device (implantable)	11	20	130	$2,890	$1.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	8	80	7,740	$30	$1.1M

Showing 1–10 of 358

Related Providers

Other providers that share a Tax Identification Number (TIN) with Saint Joseph Health System, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saint Joseph Health System, Inc	KY	General Acute Care Hospital	$0	$85.5M
Saint Joseph Health System, Inc	KY	Rural Acute Care Hospital	$0	$83.7M
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

Nearby Providers

Other providers in the same ZIP code as Saint Joseph Health System, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Scott-wilson, Inc.	KY	Home Infusion Therapy Pharmacy	$0	$24.5M
Labtox, LLC	KY	Clinical Medical Laboratory	$43.5K	$21.8M
Phi Health, LLC	KY	Air Ambulance	$2M	$13.2M
Retina And Vitreous Associates Of Kentucky PLLC	KY	Retina Specialist (Ophthalmology) Physician	$0	$13.3M
Key Assets Kentucky, Inc.	KY	Community/Behavioral Health Agency	$0	$10.8M
Grace Place Adult Day Center LLC	KY	Adult Day Care Clinic/Center	$0	$9.7M
Uhs Of Ridge LLC	KY	Psychiatric Hospital	$0	$9.1M
United Seating And Mobility LLC	KY	Durable Medical Equipment & Medical Supplies	$0	$8.6M
Ridge Outpatient Counseling, LLC	KY	Psychiatric Hospital Unit	$0	$5.2M
Baptist Health Surgery Center LLC	KY	Ambulatory Surgical Clinic/Center	$1.8M	$2.9M

Saint Joseph Health System, 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