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

Why is the Medicaid comparison limited to Connecticut 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. Connecticut (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.

Saint Francis Hospital And Medical Center (NPI 1871713495)

Field	Value
Entity Type	Organization
Organization	Saint Francis Hospital And Medical Center
Address	114 Woodland St
City	Hartford
State	CT
ZIP	06105
Taxonomy	General Acute Care Hospital
NPI Enumerated	April 26, 2007

Payer Source	Total Paid
Medicaid	$266.5M
Medicare	$0

Key Findings

SAINT FRANCIS HOSPITAL AND MEDICAL CENTER is effectively a single-payer Medicaid hospital in this dataset: there is no Medicare billing on file and all reported public payer revenue is Medicaid, with total Medicaid revenue of $266.5M. This payer concentration means analysts should treat Medicaid as the primary revenue driver when modeling the provider’s public-payor exposure and utilization patterns.

Revenue is highly concentrated in a small set of codes: the top three Medicaid codes account for 50.1% of the provider’s total Medicaid revenue. Those top three are 99285 ($50.3M, 23.7%), J2350 ($31.4M, 14.8%), and 99284 ($24.7M, 11.7%), indicating that a handful of high-volume E/M visits and one high-cost drug dominate the revenue profile.

Emergency department services are a central service line for this hospital: ED E/M codes 99285, 99284, and 99283 together represent a substantial portion of Medicaid revenue and high claim volumes (99285: 98K claims, $513 avg, $50.3M, ranks #5 of 129, 97th percentile; 99284: 80.6K claims, $307 avg, $24.7M, ranks #13 of 127, 90th percentile; 99283: 74.4K claims, $206 avg, $15.3M, ranks #14 of 114, 88th percentile). These rank positions and volumes point to a busy ED that is a primary operational and revenue-generating unit for the provider.

High-cost biologic and infusion therapy is another distinguishing feature of the billing mix: J2350 (ocrelizumab) accounts for $31.4M (14.8%) and ranks #2 of 4 providers in-state (67th percentile), while J2323 (natalizumab) contributes $15.7M (7.4%) and ranks #1 of 2 (100th percentile). Additional oncology and infusion activity is reflected in codes such as J9271 (pembrolizumab, $4.2M) and 96413 (chemotherapy administration, $3.4M), together signaling robust specialty infusion/oncology and neurology infusion capacity.

The hospital holds dominant statewide positions on several specialized, high-reimbursement procedures and support services: 93458 (coronary angiography imaging) is 2.4K claims, $1552 avg, $3.7M and ranks #1 of 17 providers in-state (100th percentile); 27447 (total knee arthroplasty) is $2.2M and ranks #1 of 8 (100th percentile); G0390 (trauma response team) is $1.7M and ranks #1 of 5 (100th percentile). These #1 rankings indicate the provider is a key destination for advanced procedural, surgical, and trauma services within Connecticut.

Outpatient clinic and high-volume diagnostic/ancillary services support the acute-care footprint: G0463 (hospital outpatient clinic visit) shows 196K claims, $93 avg, $18.2M (8.6%) and ranks #5 of 35 (88th percentile), while imaging and testing volumes such as 70450 (23.8K claims, $126 avg, $3M) and 74177 (20.5K claims, $146 avg, $3M) and COVID testing U0003 (42K claims, $67 avg, $2.8M) further reflect large throughput across ED, outpatient clinic, and diagnostics. Together these volumes are consistent with a large acute-care center with substantial ambulatory and diagnostic demand.

Several codes are flagged as notably above typical state volume or as percentile outliers, which highlights strategic strengths and potential revenue sensitivities: 99285 is described as notably above typical state volume (97th percentile), 96374 is notably above typical state volume (97th percentile), and multiple specialty codes (J2323, 93458, 27447, G0390) rank at the 100th percentile. These concentrated high-percentile positions suggest the hospital is a statewide referral point for specialty infusions, cardiac catheterization imaging, orthopedic surgery, and trauma response.

The provider has a long operational tenure in public payer datasets, with its NPI enumerated on 2007-04-26 (~19 years ago). That duration, combined with the large Medicaid footprint and top-state rankings on multiple specialty codes, indicates an established acute-care hospital whose Medicaid activity is centered on high-volume emergency, infusion/oncology, and advanced procedural services.

Medicaid: Complete Services Breakdown

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

727 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	97,960	$510	$50.3M
J2350	Injection, ocrelizumab, 1 mg	1,930	$16,260	$31.4M
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.	80,580	$310	$24.7M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	196,030	$90	$18.2M
J2323	Injection, natalizumab, 1 mg	4,110	$3,820	$15.7M
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.	74,400	$210	$15.3M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	70,020	$140	$9.8M
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…	6,030	$730	$4.4M
J9271	Injection, pembrolizumab, 1 mg	710	$5,850	$4.2M
93458	In this procedure, the provider performs imaging supervision and interpretation for a coronary angiography with left heart catheterization and intraprocedural injections for left ventriculography. He…	2,360	$1,550	$3.7M

Showing 1–10 of 727

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Connecticut Distribution

Saint Francis Hospital And Medical Center — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Connecticut

Full comparison — all codes billed, vs. Connecticut median

727 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J2350	Injection, ocrelizumab, 1 mg	2	10	1,310	$17,340	$21.6M
J2323	Injection, natalizumab, 1 mg	1	10	3,070	$3,870	$11.9M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	5	40	21,520	$90	$8M
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.	5	130	520	$330	$5.9M
J9271	Injection, pembrolizumab, 1 mg	4	10	210	$5,070	$5.8M
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.	13	130	690	$180	$4.7M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	2	40	23,540	$140	$3.7M
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.	14	110	1,520	$140	$3.4M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	10	10	330	$1,810	$3.3M
J9144	Injection, daratumumab, 10 mg and hyaluronidase‑fihj	2	10	80	$2,830	$2.7M

Showing 1–10 of 727

Related Providers

Other providers that share a Tax Identification Number (TIN) with Saint Francis Hospital And Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saint Francis Care Medical Group, PC	CT	Anatomic Pathology & Clinical Pathology Physician	$0	$2M
Danny Korkmaz	CT	Cardiovascular Disease Physician	$142.7K	$0
Anita Kelsey	CT	Cardiovascular Disease Physician	$138.3K	$0
Vincent Romano	CT	Cardiovascular Disease Physician	$130K	$0
Thalia Mesologites	CT	Anatomic Pathology & Clinical Pathology Physician	$60.3K	$0
Brian Wagner	CT	Foot Surgery Podiatrist	$49.9K	$0
Kim Ginevan	ME	Anatomic Pathology & Clinical Pathology Physician	$44.1K	$0
Gary Wilson	CT	Anesthesiology Physician	$33.8K	$0
Gary Belt	NJ	Neurology Physician	$27.6K	$0
Gayle Harris	CT	Obstetrics & Gynecology Physician	$14.2K	$0

Nearby Providers

Other providers in the same ZIP code as Saint Francis Hospital And Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Trinity Health Of New England Provider Network Organization Inc	CT	Internal Medicine Physician	$0	$42M
The Village For Families & Children, Inc.	CT	Adolescent and Children Mental Health Clinic/Center	$0	$39.5M
The Village For Families & Children, Inc.	CT	Psychiatric Residential Treatment Facility	$0	$28.4M
Collins Medical Associates 2 PC	CT	Internal Medicine Physician	$0	$9M
Saint Francis Emergency Medical Group, Inc.	CT	Emergency Medicine Physician	$0	$8.8M
Radiology Associates Of Hartford PLLC	CT	Diagnostic Radiology Physician	$0	$4.8M
Asylum Hill Family Medicine Center Inc	CT	Family Medicine Physician	$0	$4.2M
Pediatric Health Associates PC.	CT	Pediatrics Physician	$0	$2.9M
Lisa Azinheira	CT	Optician	$0	$2.6M
The Latin Enrichment Organization LLC	CT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$2.6M

Saint Francis Hospital And Medical Center — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References