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.

Lester E Cox Medical Centers (NPI 1760405864)

Field	Value
Entity Type	Organization
Organization	Lester E Cox Medical Centers
Address	1001 E Primrose St
City	Springfield
State	MO
ZIP	65807
Taxonomy	General Practice Physician
NPI Enumerated	July 26, 2006

Payer Source	Total Paid
Medicaid	$9.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

132 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	34,740	$60	$2.2M
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…	19,950	$70	$1.3M
99204	The provider sees a new 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 provider…	6,500	$130	$851.8K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	3,960	$110	$451.4K
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.	7,420	$60	$430.5K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	2,450	$160	$396.3K
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.	10,550	$30	$337.7K
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.	6,590	$50	$329.4K
99203	The provider sees a new 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 provider…	3,620	$80	$293.1K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	6,250	$40	$274.8K

Showing 1–10 of 132

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

Lester E Cox Medical Centers — 11 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

132 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	282	600	140	$170	$384.1K
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.	229	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…	283	320	980	$40	$352.7K
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.	86	950	120	$150	$288.2K
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.	126	1,260	220	$120	$242.4K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	25	30	110	$1,230	$229.7K
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…	63	160	720	$60	$218.3K
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.	42	90	120	$250	$141.3K
95811	During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.	16	30	50	$650	$137.5K
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…	51	60	510	$70	$128.9K

Showing 1–10 of 132

Related Providers

Other providers that share a Tax Identification Number (TIN) with Lester E Cox Medical Centers, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lester E Cox Medical Centers	MO	General Acute Care Hospital	$0	$112.3M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
University Medical Service Association Inc	FL	General Practice Physician	$0	$29.4M
Partners Physician Group	OH	Surgery Physician	$0	$28.5M
Lester E Cox Medical Centers	MO	Land Ambulance	$0	$25.8M
Advocates For A Healthy Community Inc	MO	Federally Qualified Health Center (FQHC)	$0	$23.2M
Quincy Physicians & Surgeons Clinic, PLLC	IL	Rural Health Clinic/Center	$0	$21.3M
Bothwell Regional Health Center	MO	General Acute Care Hospital	$0	$19.8M
Skaggs Community Hospital Association	MO	General Acute Care Hospital	$0	$18.8M
Lester E Cox Medical Centers	MO	Family Medicine Physician	$0	$17M

Nearby Providers

Other providers in the same ZIP code as Lester E Cox Medical Centers, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Supported Living And Employment Services, Inc.	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$276.6M
Easy Living Inc.	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$183.2M
Healthcare Services Of The Ozarks, Inc	MO	Home Health Agency	$0	$60.3M
Mercy Clinic Springfield Communities	MO	Family Medicine Physician	$0	$51.5M
Abilities First	MO	Case Management Agency	$0	$45.8M
Southwest Center For Independent Living	MO	In Home Supportive Care Agency	$0	$45.3M
Seniorage Area Agency On Aging	MO	Case Management Agency	$0	$19.2M
Maxim Healthcare Services, Inc.	MO	Home Health Agency	$0	$17.7M
Phoenix Home Care, LLC	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$8.5M
Honour Brite LLC	MO	Multi-Specialty Clinic/Center	$0	$7.1M

Lester E Cox Medical Centers — Billing Profile & Reimbursement Data

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Lester E Cox Medical Centers — 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