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    OpenPayerNPI Medicare & MedicaidSsm Health Care St. Louis
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    Ssm Health Care St. Louis — Billing Profile & Reimbursement Data

    NPI 1851496152 · Fenton, MO · General Acute Care Hospital

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    Ssm Health Care St. Louis is a general acute care hospital provider located in Fenton, Missouri. This profile covers 0 Medicare and 50 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationSsm Health Care St. Louis
    Address1015 Bowles Ave
    CityFenton
    StateMO
    ZIP63026
    TaxonomyGeneral Acute Care Hospital
    NPI EnumeratedSeptember 13, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$7.7M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    50 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    X4011N/A7,810$250$2M
    99284The 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.5,290$180$962.2K
    99283The 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.6,060$150$909.1K
    G0463Hospital outpatient clinic visit for assessment and management of a patient9,310$80$782.1K
    85025A 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…17,490$40$752.2K
    80053The 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.16,070$40$707K
    96374The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.4,720$110$514.3K
    93005The 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…4,550$40$172.9K
    87880The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.3,780$30$94.5K
    99282The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.1,050$70$77.4K

    Showing 1–10 of 50

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Missouri median

    50 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    X4011N/A441105,700$340$3.2M
    G0463Hospital outpatient clinic visit for assessment and management of a patient301002,240$80$2.2M
    X4003N/A47701,480$80$1.1M
    96374The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.23901,850$120$384.1K
    99285The 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.240600140$170$384.1K
    93005The 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…411102,100$70$364.3K
    80053The 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.432401,740$40$353.4K
    85025A 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…46320980$40$352.7K
    99284The 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.98950120$150$288.2K
    G0378Hospital observation service, per hour3650190$420$255.4K

    Showing 1–10 of 50

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Ssm Health Care St. Louis, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Ssm Health Care St. LouisMOGeneral Acute Care Hospital$0$50.1M
    Ssm Health Care St. LouisMOGeneral Acute Care Hospital$0$27.7M
    Ssm Medical Group, Inc.MOMulti-Specialty Clinic/Center$0$19.4M
    Ssm Health Care St. LouisMOGeneral Acute Care Hospital$0$12.4M
    Ssm Health Care St. LouisMOGeneral Acute Care Hospital$0$8.9M
    Ssm Cardinal Glennon Childrens HospitalILPediatrics Physician$0$5.4M
    Lewis MeyersonMOFamily Medicine Physician$340.9K$18K
    Usman QayyumMOInterventional Cardiology Physician$188.5K$107.8K
    Khaled Abdel-hamidMOAllergy & Immunology Physician$279.6K$15.1K
    Ali ZiaeeMOInterventional Cardiology Physician$294.4K$0

    Nearby Providers

    Other providers in the same ZIP code as Ssm Health Care St. Louis, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Thyroid Specialty Laboratory IncMOClinical Medical Laboratory$3.2M$30.2M
    Option Care Enterprises, Inc.MOHome Infusion Therapy Pharmacy$0$11.2M
    Alternative Hospice LLCMOCommunity Based Hospice Care Agency$0$4.1M
    Solutions Lab And Health Care Services LLCMOClinical Medical Laboratory$967.7K$1.4M
    Jeffrey PetersenMODermatology Physician$616.1K$0
    Fenton Fire Protection DistrictMOLand Ambulance$291.6K$304.6K
    Ssm St Clare Surgical Center LLCMOAmbulatory Surgical Clinic/Center$398K$0
    Brent DavidsonMOOphthalmology Physician$251.9K$0
    Michael BoedefeldMOPain Medicine (Anesthesiology) Physician$176.7K$4.2K
    Adam ShomsteinMOPain Medicine (Physical Medicine & Rehabilitation) Physician$150.8K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Missouri Providers
    2 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Missouri Distribution
    Ssm Health Care St. Louis — 1 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Missouri