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 1588131338)

Saint Francis Medical Center is a rural health clinic/center provider located in Sikeston, Missouri. This profile covers 0 Medicare and 37 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 Francis Medical Center
Address	1012 N Main St
City	Sikeston
State	MO
ZIP	63801
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	October 30, 2018

Payer Source	Total Paid
Medicaid	$4.7M
Medicare	$0

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

37 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	54,880	$70	$4M
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…	4,110	$50	$184.9K
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…	2,000	$70	$135.7K
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	1,970	$70	$127.9K
90961	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the…	1,590	$60	$89.2K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	2,050	$40	$82.1K
99307	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making or the…	1,320	$20	$27.6K
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…	580	$30	$16.2K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	230	$50	$11K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	450	$20	$9.9K

Showing 1–10 of 37

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 — 2 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

37 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	4	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…	85	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.	129	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…	222	320	980	$40	$352.7K
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…	111	160	720	$60	$218.3K
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	115	120	260	$50	$136.3K
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	17	60	510	$70	$128.9K
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…	446	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…	360	4,310	300	$60	$110.8K
85027	The lab analyst performs a blood count on the red and white blood cells and platelets also known as thrombocytes. He also determines the hemoglobin, typically by spectrophotometry, and the…	102	120	130	$60	$103K

Showing 1–10 of 37

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	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
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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Crossroads Isl, LLC	MO	Developmentally Disabled Services Day Training Agency	$0	$85.8M
State Of Missouri	MO	Developmentally Disabled Services Day Training Agency	$0	$45.9M
Bootheel Counseling Services	MO	Community/Behavioral Health Agency	$0	$27M
Missouri Delta Medical Center	MO	General Acute Care Hospital	$0	$22.7M
Allen Home Care Services, Inc.	MO	Nursing Care Agency	$0	$10.1M
Mosaic Community Services, LLC	MO	In Home Supportive Care Agency	$0	$6.2M
Catholic Charities Of Southern Missouri	MO	Case Management Agency	$0	$6M
Wyatt's Dream Center	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$5.1M
Knights Of Columbus 3151 St. Francis Xavier	MO	Adult Day Care Clinic/Center	$0	$4.3M
Mba In-home Services LLC	MO	In Home Supportive Care Agency	$0	$4.2M

Saint Francis Medical Center — Billing Profile & Reimbursement Data

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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

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