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

Why is the Medicaid comparison limited to Colorado 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. Colorado (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.

St. Mary's Hospital And Medical Center, Inc. (NPI 1699716027)

Field	Value
Entity Type	Organization
Organization	St. Mary's Hospital And Medical Center, Inc.
Address	2635 N 7th St
City	Grand Junction
State	CO
ZIP	81501
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 9, 2006

Payer Source	Total Paid
Medicaid	$14.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

224 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.	27,410	$110	$3M
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.	16,310	$110	$1.8M
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.	2,780	$340	$957.4K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	6,430	$110	$727K
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.	3,620	$160	$571.8K
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.	56,020	$10	$560.2K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	5,600	$90	$520.9K
J3490	Unclassified drugs	120,900	$1	$483.6K
A0430	Ambulance service, conventional air services, transport, one way (fixed wing)	160	$2,460	$383.9K
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.	3,260	$110	$365.3K

Showing 1–10 of 224

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

St. Mary's Hospital And Medical Center, Inc. — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

224 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A0430	Ambulance service, conventional air services, transport, one way (fixed wing)	6	10	270	$1,780	$1.9M
A0431	Ambulance service, conventional air services, transport, one way (rotary wing)	15	20	130	$1,830	$1.4M
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.	62	210	730	$120	$966.7K
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.	28	290	1,390	$110	$958.7K
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.	38	270	1,290	$100	$937.1K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	10	70	410	$250	$881.6K
A0425	Ground mileage, per statute mile	267	280	990	$20	$636.8K
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…	1,062	2,520	330	$100	$352K
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	38	40	110	$160	$326K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	240	310	1,750	$40	$319.9K

Showing 1–10 of 224

Related Providers

Other providers that share a Tax Identification Number (TIN) with St. Mary's Hospital And Medical Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ihc Health Services, Inc.	UT	Children's Hospital	$0	$129.5M
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$68.7M
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$65.8M
Ihc Health Services Inc	UT	General Acute Care Hospital	$0	$54.1M
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$44.3M
Ihc Health Services Inc	UT	Home Infusion Therapy Pharmacy	$0	$38.1M
Ihc Health Services Inc	UT	Durable Medical Equipment & Medical Supplies	$0	$26.9M
Ihc Health Services Inc	UT	General Acute Care Hospital	$0	$25.3M
Ihc Health Services, Inc.	UT	Clinical Medical Laboratory	$2.7M	$17.9M
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$20.4M

Nearby Providers

Other providers in the same ZIP code as St. Mary's Hospital And Medical Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Colorado West Regional Mental Health, Inc.	CO	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$84.2M
Mesa Developmental Services Dba Strive	CO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$59.6M
Tazco, Inc.	CO	Taxi	$0	$39.7M
Hilltop Health Services Corporation	CO	Adult Day Care Clinic/Center	$0	$27.7M
Hilltop Health Services Corporation	CO	Professional Counselor	$0	$24.2M
Mosaic	CO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$16.3M
Martha Amos	CO	Mental Health Counselor	$0	$14.6M
Colorado West Emergency Physicians, LLC	CO	Emergency Medicine Physician	$0	$10.6M
Mls Senior Care	CO	Homemaker	$0	$9M
Amos Counseling LLC	CO	Mental Health Counselor	$0	$6.5M

St. Mary's Hospital And Medical Center, Inc. — Billing Profile & Reimbursement Data

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St. Mary's Hospital And Medical Center, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References