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 Delaware for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Delaware 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. Delaware (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 Francis Hospital Inc. (NPI 1871647404)

St Francis Hospital Inc. is a family medicine physician provider located in Newark, Delaware. This profile covers 0 Medicare and 38 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	St Francis Hospital Inc.
Address	620 Stanton-christiana Rd
City	Newark
State	DE
ZIP	19713
Taxonomy	Family Medicine Physician
NPI Enumerated	January 22, 2007

Payer Source	Total Paid
Medicaid	$347.2K
Medicare	$0

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

38 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…	4,680	$40	$173.2K
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…	1,970	$50	$100.6K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	1,570	$10	$15.7K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	170	$80	$13K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	210	$60	$11.5K
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,…	220	$40	$7.8K
92551	The provider delivers a limited series of tones or sounds to a patient to determine if the patient’s hearing is in an acceptable range to detect hearing problems.	1,180	$10	$7.1K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	1,890	$1	$5.7K
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…	40	$110	$4.4K
90656	This code represents a preservative–free trivalent influenza vaccine product containing split virus components. It is administered into the muscle in a 0.5 mL dosage.	70	$20	$1.3K

Showing 1–10 of 38

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Delaware Distribution

St Francis Hospital Inc. — 0 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. Delaware median

38 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	203	500	1,130	$50	$235.1K
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…	48	50	1,070	$70	$226.6K
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…	44	50	1,050	$60	$191.3K
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…	125	540	1,100	$40	$185.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	39	50	800	$70	$170.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	35	50	470	$80	$126.7K
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…	140	180	220	$90	$101.5K
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…	171	190	240	$60	$90.8K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	48	50	160	$70	$51.1K
92551	The provider delivers a limited series of tones or sounds to a patient to determine if the patient’s hearing is in an acceptable range to detect hearing problems.	18	30	1,850	$10	$50.9K

Showing 1–10 of 38

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Francis Hospital Inc.	DE	General Acute Care Hospital	$0	$43.2M
St Francis Hospital Inc	DE	Ambulance	$0	$3.8M
St. Francis Hospital Inc.	DE	Family Medicine Physician	$0	$1.9M
St Francis Hospital Inc	DE	Obstetrics & Gynecology Physician	$0	$711.4K
St. Francis Hospital Inc.	DE	Obstetrics & Gynecology Physician	$0	$488.7K
David Krasner	DE	Family Medicine Physician	$467.5K	$0
St. Francis Hospital Inc.	DE	Cardiovascular Disease Physician	$0	$463.8K
Anthony Vasile	DE	Sleep Medicine (Internal Medicine) Physician	$163.4K	$68.2K
St. Francis Hospital Inc.	DE	Family Medicine Physician	$0	$199.2K
Joseph Pennington	DE	Clinical Cardiac Electrophysiology Physician	$145.7K	$0

St Francis Hospital Inc. — Billing Profile & Reimbursement Data

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St Francis Hospital 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

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