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.

Carestl Health (NPI 1972596088)

Carestl Health is a multi-specialty clinic/center provider located in Saint Louis, Missouri. This profile covers 0 Medicare and 119 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	Carestl Health
Address	5471 Dr. Martin Luther King
City	Saint Louis
State	MO
ZIP	63112
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	August 24, 2005

Payer Source	Total Paid
Medicaid	$6.7M
Medicare	$0

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

119 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…	26,100	$100	$2.6M
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…	9,640	$140	$1.3M
92015	The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced.	2,040	$110	$223.8K
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	3,270	$60	$189.5K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	5,710	$30	$171.2K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	5,380	$30	$134.5K
11056	The provider removes 2 to 4 benign hyperkeratotic lesions by using surgical instruments like a scalpel or curette.	1,570	$90	$133.4K
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,…	2,120	$60	$122.7K
80053	The 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.	6,080	$20	$121.5K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	990	$110	$112.7K

Showing 1–10 of 119

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

Carestl Health — 5 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

119 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
80053	The 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.	81	240	1,740	$40	$353.4K
85025	A 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…	81	320	980	$40	$352.7K
81001	Urinalysis is used to detect substances or cellular material in the urine associated with different metabolic and kidney disorders. It is used to detect urinary tract infections (UTI) and other…	44	160	720	$60	$218.3K
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	65	120	260	$50	$136.3K
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…	106	3,170	230	$70	$128.1K
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…	59	4,310	300	$60	$110.8K
85027	The lab analyst performs a blood count on the red and white blood cells and platelets also known as thrombocytes. He also determines the hemoglobin, typically by spectrophotometry, and the…	27	120	130	$60	$103K
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	5	50	130	$60	$82.7K
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…	298	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.	14	260	180	$60	$61.6K

Showing 1–10 of 119

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kia Washington	MO	Women's Health Nurse Practitioner	$130	$42.9K
Junaid Syed	MO	Psychiatry Physician	$16.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Betty Jean Kerr People's Health Centers	MO	Community/Behavioral Health Agency	$0	$24.6M
Beyond Care Home Services LLC	MO	Nursing Care Agency	$0	$9.4M
From The Heart Home Care LLC	MO	Home Health Agency	$0	$8.1M
Betty Jean Kerr People's Health Centers	MO	Federally Qualified Health Center (FQHC)	$0	$8.1M
Care Givers Of Christ Inc	MO	In Home Supportive Care Agency	$0	$4.5M
Ann's Touch Adult Daycare LLC	MO	Adult Day Care Clinic/Center	$0	$3.8M
Mollie Spire	MO	Family Medicine Physician	$79.5K	$0

Carestl Health — Billing Profile & Reimbursement Data

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Carestl Health — 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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