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.

Pemiscot County Memorial Hospital (NPI 1518065291)

Pemiscot County Memorial Hospital is a rural health clinic/center provider located in Hayti, Missouri. This profile covers 0 Medicare and 18 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Pemiscot County Memorial Hospital
Address	907 E Reed St
City	Hayti
State	MO
ZIP	63851
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	September 20, 2006

Payer Source	Total Paid
Medicaid	$6.5M
Medicare	$0

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

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	39,880	$90	$3.6M
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	24,990	$70	$1.7M
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	7,260	$120	$864.4K
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	970	$140	$135K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	460	$220	$102.6K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	130	$200	$26.7K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	250	$100	$24.3K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	140	$120	$16.4K
G0511	Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral…	610	$10	$6.1K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	50	$130	$6.1K

Showing 1–10 of 18

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

Pemiscot County Memorial Hospital — 3 of 16 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

18 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	142	170	2,460	$70	$498.3K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	136	3,170	230	$70	$128.1K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	39	4,310	300	$60	$110.8K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	428	680	280	$90	$65.3K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	172	420	90	$100	$60.2K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	163	190	90	$90	$59.8K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	502	640	210	$90	$59.5K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	321	580	60	$110	$42K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	535	600	110	$90	$40.2K
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	70	860	60	$70	$33.9K

Showing 1–10 of 18

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pemiscot County Memorial Hospital	MO	Rural Acute Care Hospital	$0	$10.2M
Jonathan Breslau	MN	Diagnostic Radiology Physician	$1.3M	$0
Abdullah Arshad	MO	Internal Medicine Physician	$1.1M	$50.8K
Steven Gubin	TN	Cardiovascular Disease Physician	$936.6K	$0
Ladonna Williams	MO	Psychiatric/Mental Health Nurse Practitioner	$879.5K	$2.2K
David Gubin	TN	Urology Physician	$613.8K	$0
Neil Anand	MN	Diagnostic Radiology Physician	$529.9K	$58.1K
Timothy Mcpherson	MO	Family Medicine Physician	$384.9K	$13.7K
Sergey Sorin	MO	Family Medicine Physician	$248.4K	$18.2K
Justin Bain	MO	Nephrology Physician	$263.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rayetta Smith Dba Smith And Associates Home Care	MO	Personal Care Attendant	$0	$11.5M
Cotoneaster Incorporated	MO	In Home Supportive Care Agency	$0	$6.2M
Extended Home Care, Inc.	MO	In Home Supportive Care Agency	$0	$3.4M
Lara Huffman	MO	Psychiatry Physician	$58.1K	$0

Pemiscot County Memorial Hospital — Billing Profile & Reimbursement Data

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Pemiscot County Memorial Hospital — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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