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

Why is the Medicaid comparison limited to Michigan 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. Michigan (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 (NPI 1922058551)

St Francis Hospital is a critical access hospital provider located in Escanaba, Michigan. This profile covers 0 Medicare and 245 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
Address	3401 Ludington St
City	Escanaba
State	MI
ZIP	49829
Taxonomy	Critical Access Hospital
NPI Enumerated	May 12, 2006

Payer Source	Total Paid
Medicaid	$14.4M
Medicare	$0

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

245 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	11,040	$260	$2.8M
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.	5,700	$410	$2.3M
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.	9,990	$160	$1.5M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	3,130	$190	$591.8K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	4,840	$120	$561.8K
99282	The 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.	4,560	$100	$450.9K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	11,860	$30	$403.3K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	5,210	$70	$354.6K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	2,700	$110	$296.8K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	2,390	$120	$282.5K

Showing 1–10 of 245

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

St Francis Hospital — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

245 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	124	150	5,330	$50	$2.8M
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.	136	400	1,510	$190	$2.6M
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.	133	480	1,350	$110	$1.7M
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.	149	450	1,540	$90	$1.3M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	92	150	7,610	$90	$1.2M
G0378	Hospital observation service, per hour	98	100	2,820	$180	$1.1M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	56	160	2,720	$60	$546.6K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	100	230	2,380	$90	$490K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	80	160	2,030	$60	$407.6K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	91	140	5,720	$40	$381.8K

Showing 1–10 of 245

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Francis Hospital	MI	Rural Health Clinic/Center	$0	$7.9M
Marc Knepp	IL	Pediatric Cardiology Physician	$4.9K	$214.3K
Monica Cespedes Santana	PR	Infectious Disease Physician	$7.9K	$162.2K
Daniel Maxwell	MI	Pulmonary Disease Physician	$118.6K	$0
Rudolph Evonich	WI	Clinical Cardiac Electrophysiology Physician	$105.7K	$0
Florin Stuleanu	WI	Pulmonary Disease Physician	$84K	$0
Bradley Klumb	WI	Orthopaedic Surgery Physician	$77.2K	$0
Kayela Corrigan	MI	Nurse Practitioner	$74.9K	$0
Donnevan Blake	WI	Cardiovascular Disease Physician	$74.2K	$350
Vijaya Munagala	WI	Clinical Cardiac Electrophysiology Physician	$72.3K	$120

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northern Homecare Services	MI	In Home Supportive Care Agency	$0	$38.3M
Upcap Services, Inc.	MI	Case Management Agency	$0	$13M
Bridgewood Non Profit Housing Corp	MI	Foster Care Agency	$0	$8.7M
Dlp Marquette General Hospital LLC	MI	Land Ambulance	$1.1M	$4.4M
Darrell Kohli	MI	Ophthalmology Physician	$250.7K	$0
Guardian Flight LLC	MI	Air Ambulance	$229.7K	$0
Roderick Hood	MI	Physician Assistant	$192K	$0
Kimber Gauthier	MI	Family Medicine Physician	$139.2K	$0
Walgreen Co	MI	Pharmacy	$136.7K	$0
Stephen Manier	MI	Diagnostic Radiology Physician	$115.9K	$0

St Francis Hospital — Billing Profile & Reimbursement Data

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St Francis Hospital — 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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