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.

Poplar Bluff Regional Medical Center LLC (NPI 1700831724)

Field	Value
Entity Type	Organization
Organization	Poplar Bluff Regional Medical Center LLC
Address	3100 Oak Grove Rd.
City	Poplar Bluff
State	MO
ZIP	63901
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 24, 2006

Payer Source	Total Paid
Medicaid	$71.6M
Medicare	$0

Key Findings

POPLAR BLUFF REGIONAL MEDICAL CENTER LLC is effectively a single-payer hospital in the dataset: it has no Medicare billing on file and $71.6M in lifetime Medicaid revenue, so all observed claims activity and financial scale in this profile are driven by Medicaid. This concentration implies payer exposure and contracting dynamics are centered on state Medicaid programs rather than Medicare reimbursement streams.

Revenue concentration is high at the code level: the provider's top 3 Medicaid codes by revenue account for 40.7% of its total Medicaid revenue, with Y7506 generating $10.9M (18.3%), X4011 $7.2M (12.0%), and 99284 $6.3M (10.5%). These three codes dominate the provider's Medicaid receipts and therefore drive service priorities and resource allocation.

The code mix signals a high-volume emergency and acute-care operation. Emergency department E/M codes 99284 ($6.3M; 10.5%) and 99283 ($4.7M; 7.8%) appear near the top of revenue lists and multiple high-acuity ED codes are present (including 99285), indicating substantial ED throughput and moderate-to-high acuity case mix alongside inpatient observation services such as G0378.

Diagnostic and laboratory services are a major ancillary revenue stream: high-volume lab panels and tests 85025 (91.4K claims, $4.2M; 7.0%) and 80053 (79.6K claims, $2.8M; 4.7%) rank in the 99th percentile statewide, and point-of-care tests like 87804 (24.9K claims, $1.1M) rank #1 of 827 providers (100th percentile). This pattern underlines a heavy emphasis on in-hospital lab diagnostics supporting ED and inpatient care.

Endoscopy and procedural gastroenterology are significant service lines. Upper endoscopy with biopsy 43239 ($1.5M; 2.5%) ranks #2 of 89 providers (99th percentile) and related procedure 43249 ($959K; 1.6%) ranks #2 of 7 providers (83rd percentile), while colonoscopy with biopsy 45380 ($1.1M; 1.8%) ranks #1 of 34 providers (100th percentile), collectively indicating a regional procedural concentration in GI services.

On competitive standing within Missouri, the hospital is a statewide outlier or high-volume performer for many codes. Notable examples include 99284 and 99283 both described as "extreme outlier, far above typical state volume" (99284 ranks #7 of 953, 99283 ranks #15 of 1263), and lab/diagnostic codes like 85025, 80053, and 87804 all sit at or near the 99th–100th percentiles, signaling the facility is a dominant provider for several core Medicaid services.

There are several high-cost, less-frequent codes contributing materially to revenue and pointing to specialty capabilities: D7999 ($1.1M; 1.9%) and X4006 ($3.9M; 6.5%) are among the top 25 Medicaid codes by revenue despite smaller claim counts, suggesting occasional higher-priced interventions or supplies factor into the hospital's revenue mix. These items complement the steady volume from ED, lab, and endoscopy services.

The provider has long-standing enrollment: the NPI enumerated 2006-05-24 (~20 years ago). This tenure, combined with the high statewide ranks on many codes, suggests an established regional role in delivering ED, diagnostic laboratory, and endoscopic services to the Medicaid population rather than a new market entrant.

Medicaid: Complete Services Breakdown

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

244 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
Y7506	N/A	21,150	$520	$10.9M
X4011	N/A	29,970	$240	$7.2M
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.	36,370	$170	$6.3M
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.	34,240	$140	$4.7M
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…	91,450	$50	$4.2M
X4006	N/A	4,590	$850	$3.9M
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.	79,550	$40	$2.8M
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.	10,970	$230	$2.5M
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.	5,170	$290	$1.5M
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…	24,260	$60	$1.4M

Showing 1–10 of 244

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

Poplar Bluff Regional Medical Center LLC — 15 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

244 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
X4011	N/A	7	110	5,700	$340	$3.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	31	100	2,240	$80	$2.2M
Y7506	N/A	9	100	980	$250	$1.6M
X4003	N/A	38	70	1,480	$80	$1.1M
X4006	N/A	4	50	370	$780	$969.5K
D7999	N/A	7	20	190	$2,300	$708.3K
Y7507	N/A	8	50	270	$360	$594.9K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	7	90	1,850	$120	$384.1K
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.	36	600	140	$170	$384.1K
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…	5	110	2,100	$70	$364.3K

Showing 1–10 of 244

Related Providers

Other providers that share a Tax Identification Number (TIN) with Poplar Bluff Regional Medical Center LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Edward Reese	MO	Family Medicine Physician	$53.7K	$0
Ruth Hampton	MO	Nurse Practitioner	$8.9K	$590

Nearby Providers

Other providers in the same ZIP code as Poplar Bluff Regional Medical Center LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
State Of Missouri	MO	Developmentally Disabled Services Day Training Agency	$0	$37.1M
Independent Living Center Of Southeast Missouri, Inc.	MO	Case Management Agency	$0	$27.3M
State Of Missouri	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$16.2M
Southern Care And Comfort In Home Agency, LLC	MO	In Home Supportive Care Agency	$0	$15.3M
Ozark Behavioral Health, LLC	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$14.2M
Tri-county Group Xv, Inc.	MO	Home Health Agency	$0	$13.9M
Butler County Ems LLC	MO	Land Ambulance	$1.2M	$8.8M
Poplar Bluff Hma Physician Management, LLC	MO	Family Medicine Physician	$0	$9.9M
Saint Francis Medical Center	MO	Rural Health Clinic/Center	$0	$8.8M
Saint Francis Medical Center	MO	Rural Health Clinic/Center	$0	$7.5M

Poplar Bluff Regional Medical Center LLC — Billing Profile & Reimbursement Data

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Poplar Bluff Regional Medical Center LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References