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.

St. Claire Medical Center, Inc (NPI 1760477848)

Field	Value
Entity Type	Organization
Organization	St. Claire Medical Center, Inc
Address	360 Pine Crest Rd
City	Morehead
State	KY
ZIP	40351
Taxonomy	Home Health Agency
NPI Enumerated	September 15, 2005

Payer Source	Total Paid
Medicaid	$3.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	31,210	$70	$2M
G0151	Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes	9,150	$60	$530.9K
G0152	Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes	5,150	$50	$272.8K
G0157	Services performed by a qualified physical therapist assistant in the home health or hospice setting, each 15 minutes	2,810	$40	$121K
G0300	Direct skilled nursing services of a licensed practical nurse (LPN) in the home health or hospice setting, each 15 minutes	1,430	$60	$81.7K
G0158	Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes	830	$40	$30.6K
T4541	Incontinence product, disposable underpad, large, each	380	$40	$15.5K
A6216	Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing	1,470	$10	$7.4K
A6260	Wound cleansers, any type, any size	400	$10	$4K
G0153	Services performed by a qualified speech‑language pathologist in the home health or hospice setting, each 15 minutes.	130	$30	$3.6K

Showing 1–10 of 20

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

St. Claire Medical Center, Inc — 2 of 17 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

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T4541	Incontinence product, disposable underpad, large, each	26	40	1,670	$210	$1.4M
Q5001	Hospice or home health care provided in patient's home/residence	23	70	310	$180	$542K
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	6	100	3,770	$40	$302.1K
G0151	Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes	3	60	790	$70	$172.6K
A9999	Miscellaneous dme supply or accessory, not otherwise specified	9	10	490	$40	$82.8K
T4542	Incontinence product, disposable underpad, small size, each	2	10	2,320	$30	$78.7K
G0152	Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes	3	30	740	$60	$73.5K
G0156	Services of home health/hospice aide in home health or hospice settings, each 15 minutes	24	30	3,210	$1	$55.6K
G0300	Direct skilled nursing services of a licensed practical nurse (LPN) in the home health or hospice setting, each 15 minutes	18	50	720	$40	$53K
G0153	Services performed by a qualified speech‑language pathologist in the home health or hospice setting, each 15 minutes.	3	10	120	$70	$47.6K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Claire Medical Center Inc	KY	General Acute Care Hospital	$0	$71.2M
St Claire Medical Center Inc.	KY	Emergency Medicine Physician	$0	$4M
St. Claire Medical Center, Inc	KY	Family Medicine Physician	$0	$3.3M
St Claire Medical Center, Inc.,	KY	Cardiovascular Disease Physician	$0	$3.3M
Tariq Mahmood	OK	Medical Oncology Physician	$253.8K	$17.8K
Eusebio Desuyo	ND	Pulmonary Disease Physician	$132.6K	$0
Matthew Shotwell	KY	Interventional Cardiology Physician	$109.3K	$0
Samuel Quaynor	GA	Neurology Physician	$93.9K	$14.6K
Steven Koenig	KY	Pulmonary Disease Physician	$104.5K	$0
Obiora Maludum	TN	Interventional Cardiology Physician	$104.3K	$0

Nearby Providers

Other providers in the same ZIP code as St. Claire Medical Center, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Edgewater Recovery Center LLC	KY	Substance Abuse Rehabilitation Facility	$0	$50.3M
D&s Residential Services, LP	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$33.6M
Gateway Area Development District	KY	Supports Brokerage Agency	$0	$20.8M
Lincare Inc.	KY	Durable Medical Equipment & Medical Supplies	$0	$3.4M
St Claire Medical Center, Inc	KY	Urgent Care Clinic/Center	$0	$3.3M
Rowan County Fiscal Court	KY	Land Ambulance	$384.7K	$767.5K
Christian Weigel	KY	Internal Medicine Physician	$105K	$0
Andrei Korossy	KY	Physical Therapist	$89.6K	$0
Lacinda Rishel	KY	Physician Assistant	$82.7K	$0
Alisha Perry	KY	Physician Assistant	$55.1K	$0

St. Claire Medical Center, Inc — Billing Profile & Reimbursement Data

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St. Claire 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