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 1578513016)

Field	Value
Entity Type	Organization
Organization	Saint Francis Medical Center
Address	211 Saint Francis Dr
City	Cape Girardeau
State	MO
ZIP	63703
Taxonomy	Internal Medicine Physician
NPI Enumerated	May 12, 2006

Payer Source	Total Paid
Medicaid	$11.7M
Medicare	$0

Medicaid: Complete Services Breakdown

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

161 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…	64,130	$50	$3.3M
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…	49,950	$60	$2.9M
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…	5,780	$70	$427.9K
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…	4,000	$110	$424.2K
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…	3,330	$100	$323K
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…	3,520	$90	$303.1K
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	660	$420	$273.1K
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,…	5,720	$40	$228.7K
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…	1,440	$140	$195.4K
62323	The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the lumbar (lower back) or sacral (caudal, or tailbone)…	1,670	$110	$182.2K

Showing 1–10 of 161

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 — 12 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

161 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	169	170	2,460	$70	$498.3K
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…	94	110	2,100	$70	$364.3K
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.	234	240	1,740	$40	$353.4K
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…	312	320	980	$40	$352.7K
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.	829	950	120	$150	$288.2K
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.	684	1,260	220	$120	$242.4K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	26	30	110	$1,230	$229.7K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	17	20	30	$450	$147.8K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	14	90	120	$250	$141.3K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	10	30	90	$340	$140.3K

Showing 1–10 of 161

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	General Acute Care Hospital	$0	$56.4M
Christus Trinity Clinic Texas	TX	Family Medicine Physician	$0	$22.2M
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

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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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References