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.

Saint Francis Medical Center (NPI 1467412726)

Field	Value
Entity Type	Organization
Organization	Saint Francis Medical Center
Address	211 St Francis Drive
City	Cape Girardeau
State	MO
ZIP	63703
Taxonomy	General Acute Care Hospital
NPI Enumerated	March 23, 2006

Payer Source	Total Paid
Medicaid	$56.4M
Medicare	$0

Key Findings

SAINT FRANCIS MEDICAL CENTER reports no Medicare billing on file and $56.4M in lifetime Medicaid revenue, making Medicaid the effective sole payer in the dataset. This provider's NPI was enumerated on 2006-03-23 (≈20 years ago), indicating an established presence but a dataset profile concentrated entirely in Medicaid.

Revenue concentration is high: the top three Medicaid codes (Y7506, X4011, Y7507) together account for 40.2% of the provider's total Medicaid revenue. Individually, Y7506 accounts for $7.6M (15.4%), X4011 for $6.9M (14.0%), and Y7507 for $5.3M (10.8%), indicating dependence on a small set of high-revenue lines.

Service-line mix shows a heavy emergency and outpatient throughput. Emergency department E/M codes 99284 (15.1K claims, $2.2M, 4.5%) and 99283 (12.2K claims, $1.4M, 2.9%) are both reported at high state percentiles (99284 at the 96th and 99283 at the 96th), and outpatient clinic visits billed under G0463 (52.3K claims, $3.2M, 6.5%) further point to substantial front-door volume for both moderate- and lower-complexity acute care.

The provider is a major in-state lab and diagnostics hub: routine lab panels and tests such as 85025 (53.7K claims, $3.2M, 6.5%), 80053 (51.4K claims, $2.9M, 5.9%), and 81001 (20.9K claims, $2.1M, 4.2%) all rank at or above the 97th–98th state percentiles. High volumes in standard lab codes alongside PLA code 0202U (3.5K claims, $1.2M, 2.4%) ranked #2 of 22 (95th percentile) suggest substantial on-site molecular/respiratory testing capacity.

A small number of high-cost line items support specialty diagnostic work: 88304 (surgical pathology level III) has a high average paid/claim ($2067) and generates $737.9K (1.5%), ranking #14 of 70 (81st percentile). Concurrently, J3490 (unclassified drugs) contributes $2.7M (5.5%) with 6.6K claims (84th percentile), indicating meaningful revenue tied to drug administrations or miscellaneous medication billing.

Competitive standing is mixed but strong in several Medicaid lines: Y7507 ranks #2 of 48 providers statewide (98th percentile) and therefore represents a clear outlier in state volume for that code, while major lab panels (85025 and 80053) sit in the 97th percentile and rank in the top decile of in-state providers. At the same time, several other high-revenue codes (e.g., Y7506 and X4011) are described as typical or unremarkable in state volume despite large dollar values, so the hospital is both a dominant provider for certain specialized items and a routine-volume provider for others.

Operational indicators show substantial monitoring and procedure activity consistent with an acute-care hospital: oxygen saturation checks (94761, 17.8K claims, $1.2M, 2.4%) rank #2 of 13 (92nd percentile), and IV medication administration (96374, 7.3K claims, $755.5K, 1.5%) ranks in the 90th percentile. These patterns align with sustained inpatient and emergency department care and significant throughput of monitored patients.

For payer/provider analysts, two implications are immediate: because Medicare billing is absent, comparative Medicare performance benchmarking is not possible for this entity in the dataset, and the provider’s financial profile is concentrated in Medicaid with 40.2% of Medicaid revenue coming from three codes (Y7506, X4011, Y7507). That concentration combined with strong state-percentile placements on high-volume lab and ED codes suggests both a competitive position in regional Medicaid services and exposure to shifts in Medicaid policy or reimbursement for those specific codes.

Medicaid: Complete Services Breakdown

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

259 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
Y7506	N/A	22,170	$350	$7.6M
X4011	N/A	24,090	$290	$6.9M
Y7507	N/A	10,540	$510	$5.3M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	52,280	$60	$3.2M
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…	53,700	$60	$3.2M
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.	51,380	$60	$2.9M
J3490	Unclassified drugs	6,580	$410	$2.7M
X4006	N/A	2,810	$870	$2.5M
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.	15,080	$150	$2.2M
81001	Urinalysis is used to detect substances or cellular material in the urine associated with different metabolic and kidney disorders. It is used to detect urinary tract infections (UTI) and other…	20,940	$100	$2.1M

Showing 1–10 of 259

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

Saint Francis Medical Center — 9 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

259 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
X4011	N/A	12	110	5,700	$340	$3.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	13	100	2,240	$80	$2.2M
Y7506	N/A	7	100	980	$250	$1.6M
X4003	N/A	13	70	1,480	$80	$1.1M
X4006	N/A	5	50	370	$780	$969.5K
Y7507	N/A	2	50	270	$360	$594.9K
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	5	30	80	$120	$440.4K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	10	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.	337	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…	18	110	2,100	$70	$364.3K

Showing 1–10 of 259

Related Providers

Other providers that share a Tax Identification Number (TIN) with Saint Francis Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saint Francis Medical Center	MO	Internal Medicine Physician	$0	$11.7M
Saint Francis Medical Center	MO	Rural Health Clinic/Center	$0	$8.8M
Saint Francis Medical Center	MO	Rural Health Clinic/Center	$0	$7.5M
Saint Francis Medical Center	MO	Rural Health Clinic/Center	$0	$4.7M
Charles Moon	MO	Dermatology Physician	$2.7M	$0
Justin Floyd	IL	Medical Oncology Physician	$1.3M	$336.2K
Alex Dwuma	OK	Internal Medicine Physician	$820.6K	$0
Saint Francis Medical Center	MO	Clinical Medical Laboratory	$296.9K	$471K
Saint Francis Medical Center	MO	Radiology Clinic/Center	$162.8K	$580.1K
John Bauer	MO	Internal Medicine Physician	$628.2K	$0

Nearby Providers

Other providers in the same ZIP code as Saint Francis Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Counseling Center	MO	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$91.4M
Semo Alliance For Disability Independence, Inc.	MO	Attendant Care Provider	$0	$27.3M
Regency Management, Inc	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$18M
Blue Sky Cimmunity Services	MO	Developmentally Disabled Services Day Training Agency	$0	$14M
Semo Alliance For Disability Independence	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$9.3M
Crown Hospice Inc	MO	Community Based Hospice Care Agency	$0	$8.3M
Cape Radiology Group, P.C.	MO	Diagnostic Radiology Physician	$0	$5.5M
David Westrich	MO	Retina Specialist (Ophthalmology) Physician	$3.3M	$0
Doctors Park Surgery Inc	MO	Ambulatory Surgical Clinic/Center	$1.2M	$0
Silver Springs Surgery Center LLC	MO	Ambulatory Surgical Clinic/Center	$413.3K	$744.3K

Saint Francis Medical Center — 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