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.

Mercy Clinic East Communities (NPI 1851335228)

Mercy Clinic East Communities is a internal medicine physician provider located in Saint Louis, Missouri. This profile covers 0 Medicare and 92 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	Mercy Clinic East Communities
Address	615 S New Ballas Rd
City	Saint Louis
State	MO
ZIP	63141
Taxonomy	Internal Medicine Physician
NPI Enumerated	June 16, 2006

Payer Source	Total Paid
Medicaid	$22.2M
Medicare	$0

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

92 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…	123,650	$70	$8.9M
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…	60,070	$80	$4.9M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	24,660	$100	$2.6M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	18,720	$100	$1.9M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	7,720	$110	$825.8K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	8,530	$60	$494.9K
90698	This code represents a combination vaccine product administered into the muscle to protect against five diseases: diphtheria, tetanus, pertussis, Haemophilus influenzae type b (Hib), and polio.	10,030	$40	$371.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,820	$110	$307.8K
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…	1,450	$120	$166.2K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	2,260	$70	$156.1K

Showing 1–10 of 92

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

Mercy Clinic East Communities — 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

92 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87430	The lab analyst performs an assay to evaluate the patient’s sample for antigens to Streptococcus, group A, using an immunoassay method, such as EIA.	4	40	200	$160	$143.1K
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…	20	3,170	230	$70	$128.1K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	150	590	260	$40	$120.5K
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…	4	4,310	300	$60	$110.8K
87400	The lab analyst performs the technical lab test to detect antigens of influenza A or B using an immunoassay technique, such as EIA. This analysis will distinguish if a patient has influenza A or B.	35	70	130	$190	$97.4K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	29	190	270	$70	$91.4K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	91	270	430	$30	$77.9K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	133	350	370	$20	$65.6K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1	680	280	$90	$65.3K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	102	260	180	$60	$61.6K

Showing 1–10 of 92

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Hospitals East Communities	MO	General Acute Care Hospital	$0	$56.5M
Mercy Hospital Jefferson	MO	General Acute Care Hospital	$0	$27.8M
Mercy Hospitals East Communities	MO	General Acute Care Hospital	$0	$25.3M
Compass Health, Inc.	MO	Federally Qualified Health Center (FQHC)	$0	$8.4M
Marissa Lewis	MO	Emergency Medicine Physician	$660.4K	$0
Gregory Galakatos	MO	Orthopaedic Surgery Physician	$292.4K	$0
Jennifer Page	MO	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$239.5K	$0
Harmeen Chawla	MO	Physical Medicine & Rehabilitation Physician	$237.5K	$0
Susan Yang	MO	Internal Medicine Physician	$218.4K	$0
Michael Gerardo	MO	Internal Medicine Physician	$213K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bayada Home Health Care, Inc.	MO	Home Health Agency	$0	$41.2M
Excel Home Care, Inc.	MO	Home Health Agency	$0	$19.8M
Biotech X-ray Inc	MO	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	$5.1M	$6M
Western Anesthesiology Associates, Inc.	MO	Anesthesiology Physician	$0	$10.9M
Team Select Home Care Of Missouri, Inc.	MO	Nursing Care Agency	$0	$10.7M
Physician Groups Lc	MO	Multi-Specialty Clinic/Center	$0	$9.8M
Sensory Solutions, LLC	MO	Occupational Therapist	$0	$7.3M
Excel Home Care, Inc.	MO	Home Health Agency	$0	$6.2M
Independent Home Care, Inc	MO	Homemaker	$0	$5.7M
West County Radiological Group, Inc.	MO	Diagnostic Radiology Physician	$0	$5.4M

Mercy Clinic East Communities — Billing Profile & Reimbursement Data

Sign up for Mercy Clinic East Communities — Billing Profile & Reimbursement Data policy alerts

Mercy Clinic East Communities — Billing Profile & Reimbursement Data

Sign up for Mercy Clinic East Communities — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References