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 Nevada for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Nevada 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. Nevada (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 Marys Medical Group Inc. (NPI 1538424239)

Saint Marys Medical Group Inc. is a primary care clinic/center provider located in Reno, Nevada. This profile covers 0 Medicare and 51 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	Saint Marys Medical Group Inc.
Address	411 W 6th St
City	Reno
State	NV
ZIP	89503
Taxonomy	Primary Care Clinic/Center
NPI Enumerated	July 9, 2012

Payer Source	Total Paid
Medicaid	$3.1M
Medicare	$0

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

51 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	21,160	$30	$613.8K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	4,720	$130	$590.1K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	11,890	$50	$558.8K
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…	11,180	$50	$514.4K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	3,840	$90	$337.8K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	3,230	$50	$155.2K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	4,830	$30	$149.6K
97597	The provider excises devitalized (dead) tissue from an open wound, choosing from a variety of techniques; treatment may include topical application of medicine or materials, wound assessment,…	1,070	$40	$39.7K
99245	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a high level of medical decision making or the provider spends…	290	$80	$24.2K
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…	480	$40	$19.2K

Showing 1–10 of 51

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Nevada providers billing the same CPT/HCPCS codes.

Claims Volume vs. Nevada Distribution

Saint Marys Medical Group Inc. — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nevada

Full comparison — all codes billed, vs. Nevada median

51 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	207	350	240	$110	$685.4K
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.	259	400	200	$90	$442.5K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	11	90	190	$160	$332.4K
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.	360	390	200	$60	$289.8K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	34	470	380	$70	$281.2K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	32	430	500	$40	$214.4K
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	39	50	120	$240	$209.3K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	34	430	180	$130	$158K
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…	96	2,250	290	$60	$138K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	8	170	180	$80	$120.5K

Showing 1–10 of 51

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Inder Singh	CA	Interventional Cardiology Physician	$4.7M	$0
Guy Jones	NV	Radiation Oncology Physician	$2.5M	$0
Jason Kehrer	NV	Radiation Oncology Physician	$1.2M	$0
Sunil Agarwal	IL	Interventional Cardiology Physician	$340.9K	$146.5K
Devang Desai	NV	Cardiovascular Disease Physician	$390.8K	$0
Ram Challapalli	NV	Cardiovascular Disease Physician	$366.7K	$0
Bogdan Sima	NV	Hospitalist Physician	$348.7K	$0
Garth Tormoen	NV	Radiation Oncology Physician	$321K	$0
Sridevi Challapalli	NV	Cardiovascular Disease Physician	$311.2K	$840
Ileana Deftu	NV	Internal Medicine Physician	$282.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prime Healthcare Services - Reno LLC	NV	General Acute Care Hospital	$0	$15.2M
Northern Nevada Hiv Outpatient Program, Education And Services	NV	Federally Qualified Health Center (FQHC)	$0	$8M
Reno Emergency Physicians Association, PLLC	NV	Emergency Medicine Physician	$0	$7.7M
The Life Change Center	NV	Addiction (Substance Use Disorder) Psychologist	$201.5K	$5.7M
Reno Orthopaedic Surgery Center LLC	NV	Ambulatory Surgical Clinic/Center	$5.3M	$0
Ridge House, Incorporated.	NV	Substance Abuse Rehabilitation Facility	$0	$2.1M
Cba Healthcare, LLC	NV	Community/Behavioral Health Agency	$0	$1.9M
Western Pathology Consultants, Ltd	NV	Clinical Pathology/Laboratory Medicine Physician	$503.1K	$553.9K
Surgery Center Of Reno, LLC	NV	Ambulatory Surgical Clinic/Center	$371K	$200.3K
Chad Watts	NV	Adult Reconstructive Orthopaedic Surgery Physician	$523.3K	$0

Saint Marys Medical Group Inc. — 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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