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

Why is the Medicaid comparison limited to Kentucky 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. Kentucky (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 Joseph Health System, Inc (NPI 1679679146)

Saint Joseph Health System, Inc is a general acute care hospital provider located in Mt Sterling, Kentucky. This profile covers 0 Medicare and 309 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 Joseph Health System, Inc
Address	225 Falcon Dr
City	Mt Sterling
State	KY
ZIP	40353
Taxonomy	General Acute Care Hospital
NPI Enumerated	September 15, 2006

Payer Source	Total Paid
Medicaid	$37.2M
Medicare	$0

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

309 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	29,300	$120	$3.6M
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.	23,880	$150	$3.5M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	5,950	$560	$3.3M
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.	15,930	$160	$2.5M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	1,890	$920	$1.7M
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	3,680	$430	$1.6M
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	6,250	$200	$1.2M
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…	2,460	$400	$975.8K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	14,380	$60	$877.4K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	11,120	$60	$700.8K

Showing 1–10 of 309

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Saint Joseph Health System, Inc — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

309 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	272	310	830	$120	$3.7M
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.	60	280	7,150	$150	$3M
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.	50	240	4,710	$150	$2.6M
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.	42	280	5,700	$120	$2M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	13	40	740	$1,170	$1.7M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	54	180	1,870	$280	$1.5M
G0378	Hospital observation service, per hour	67	90	2,770	$190	$1.3M
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	26	30	2,320	$290	$1.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	52	80	7,740	$30	$1.1M
C1713	Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)	25	40	550	$910	$1.1M

Showing 1–10 of 309

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saint Joseph Health System, Inc	KY	General Acute Care Hospital	$0	$85.5M
Saint Joseph Health System, Inc	KY	Rural Acute Care Hospital	$0	$83.7M
Saint Joseph Health System, Inc	KY	General Acute Care Hospital	$0	$67.4M
Kentuckyone Health Medical Group, Inc.	KY	Family Medicine Physician	$0	$38.9M
Saint Joseph Health System, Inc	KY	Critical Access Hospital	$0	$29.8M
Robert Lavey	KY	Radiation Oncology Physician	$384.3K	$0
Emmanuel Nidhiry	KY	Medical Oncology Physician	$347.6K	$0
Nicola Jabbour	KY	Hematology & Oncology Physician	$195.8K	$0
Aman Khurana	IL	Internal Medicine Physician	$152.8K	$41.4K
Muhammad Niazi	KY	Hematology & Oncology Physician	$91.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sterling Health Solutions, Inc	KY	Federally Qualified Health Center (FQHC)	$0	$12.4M
Oral Surgery & Implant Associates	KY	Oral and Maxillofacial Surgery (Dentist)	$0	$4.9M
Bless The Lord Church, Inc	KY	Substance Abuse Rehabilitation Facility	$0	$4.6M
Wecare Medical LLC	KY	Oxygen Equipment & Supplies (DME)	$0	$3.5M
Mt. Sterling Pediatrics	KY	Pediatrics Physician	$0	$3.3M
John I Gray Iii Psc	KY	Oral and Maxillofacial Surgery (Dentist)	$0	$3.2M
Donald Mclaurin	KY	Oral and Maxillofacial Surgery (Dentist)	$0	$3.2M
Mt. Sterling Pediatrics Psc	KY	Rural Health Clinic/Center	$0	$2.9M
Community Family Clinic PLLC	KY	Rural Health Clinic/Center	$0	$2.8M
Montgomery County Ambulance	KY	Land Ambulance	$406K	$1M

Saint Joseph Health System, 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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