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

Why is the Medicaid comparison limited to Tennessee 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. Tennessee (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 Thomas West Hospital (NPI 1629025648)

Field	Value
Entity Type	Organization
Organization	Saint Thomas West Hospital
Address	4220 Harding Rd
City	Nashville
State	TN
ZIP	37205
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 27, 2006

Payer Source	Total Paid
Medicaid	$7.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

90 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	23,710	$140	$3.2M
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.	19,730	$100	$2M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	9,430	$40	$339.6K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	3,760	$80	$293.3K
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.	1,340	$170	$224.1K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	3,230	$50	$171.2K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	3,100	$30	$102.2K
G0378	Hospital observation service, per hour	420	$230	$96.3K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	8,160	$10	$81.6K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	750	$90	$63.6K

Showing 1–10 of 90

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Saint Thomas West Hospital — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

90 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	16	60	1,340	$50	$1.1M
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.	56	630	510	$120	$1.1M
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.	57	610	570	$110	$884.4K
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.	162	570	640	$100	$637.8K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	59	100	400	$60	$524.7K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	80	100	670	$60	$342.9K
G0378	Hospital observation service, per hour	48	100	410	$210	$264K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	123	240	840	$20	$259.2K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	81	180	480	$90	$245.5K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	38	120	3,760	$30	$225K

Showing 1–10 of 90

Related Providers

Other providers that share a Tax Identification Number (TIN) with Saint Thomas West Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sacred Heart Health System, Inc.	FL	General Acute Care Hospital	$0	$38.5M
Saint Thomas Rutherford Hospital	TN	General Acute Care Hospital	$0	$16.2M
Ascension Sacred Heart Emerald Coast	FL	General Acute Care Hospital	$0	$11.9M
St Vincents Ambulatory Care Inc	FL	Neurological Surgery Physician	$0	$10.4M
Saint Thomas River Park Hospital, LLC	TN	General Acute Care Hospital	$0	$8.4M
Saint Thomas Highlands Hospital, LLC	TN	General Acute Care Hospital	$0	$3.3M
The Surgery Center Of Jacksonville LLC	FL	Ambulatory Surgical Clinic/Center	$1M	$0
Saumil Oza	FL	Clinical Cardiac Electrophysiology Physician	$550K	$0
Anthony Magnano	FL	Clinical Cardiac Electrophysiology Physician	$436.2K	$0
Mariano Mikulic	FL	Cardiovascular Disease Physician	$391.9K	$0

Nearby Providers

Other providers in the same ZIP code as Saint Thomas West Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Old Harding Pediatric Associates	TN	Pediatrics Physician	$0	$7.3M
Adams & Seaton Pediatric Dentistry	TN	Pediatric Dentistry	$0	$3.7M
Kent Shih	TN	Hematology & Oncology Physician	$2.2M	$0
Joshua Mondschein	TN	Radiation Oncology Physician	$2.1M	$0
Saint Thomas Campus Surgicare LP	TN	Ambulatory Surgical Clinic/Center	$1.3M	$0
Elizabeth Lyons	TN	Rheumatology Physician	$1.2M	$0
Colt Mcclain	TN	Anatomic Pathology & Clinical Pathology Physician	$962.9K	$0
Imaging Alliance Nashville Pet LLC	TN	Radiology Clinic/Center	$456.7K	$255.5K
Gregg Shepard	TN	Hematology & Oncology Physician	$653K	$0
Heikki Kostamaa	TN	Retina Specialist (Ophthalmology) Physician	$608K	$0

Saint Thomas West 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

Related Providers

Nearby Providers

Frequently Asked Questions

References