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

Why is the Medicaid comparison limited to Kentucky 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. Kentucky (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 Joseph Health System, Inc (NPI 1992701429)

Key Findings

Field	Value
Entity Type	Organization
Organization	Saint Joseph Health System, Inc
Address	1001 Saint Joseph Ln
City	London
State	KY
ZIP	40741
Taxonomy	Rural Acute Care Hospital
NPI Enumerated	June 21, 2005

Payer Source	Total Paid
Medicaid	$83.7M
Medicare	$0

SAINT JOSEPH HEALTH SYSTEM, INC has no Medicare billing on file and reports $83.7M in lifetime Medicaid revenue, making its financial footprint effectively single‑payer and highly Medicaid‑dependent in the available claims data. This profile suggests operational focus and revenue risk are concentrated within Medicaid reimbursements rather than a mixed Medicare/Medicaid payer mix.

Revenue is concentrated in a small set of high‑volume Medicaid codes: the precomputed top three Medicaid codes account for 42.8% of the provider's total Medicaid revenue. The single largest contributors among those top codes are 99284 ($9.6M, 16.8%), 74177 ($7.7M, 13.4%), and 99285 ($7.2M, 12.6%), indicating a narrow set of services driving much of the hospital's Medicaid income.

The provider shows a heavy emergency department footprint: 99284 (46.3K claims, $9.6M revenue) and 99285 (26.4K claims, $7.2M revenue) sit among the top revenue drivers, and 99283 adds further volume (43.8K claims, $6.2M revenue). State ranking/percentile data (99284: #25 of 282, 91th percentile; 99285: #30 of 239, 88th percentile; 99283: #19 of 284, 94th percentile) indicate the hospital handles large ED volumes across low, moderate, and high decision‑making visits, consistent with a rural acute care facility functioning as a regional emergency access point.

Cross‑sectional imaging and diagnostic services are also material revenue sources: 74177 (CT abdomen/pelvis with contrast, $7.7M, 13.4%), 74176 (CT without contrast, $3.3M, 5.8%), and 70450 (head CT without contrast, $3.0M, 5.2%) are all in the top revenue list. These imaging volumes—paired with ranks in the 80–90th percentiles for several CT and MRI codes—point to a well‑utilized diagnostic imaging service line supporting ED and inpatient workflows.

Cardiac testing is a notable ancillary service line: 93306 (echocardiography, $2.9M, 5.1%) and 93005 (ECG without interpretation, $1.8M, 3.1%) show steady volumes, while nuclear cardiology 78452 ($1.6M, 2.9%) ranks #7 of 131 providers in‑state (95th percentile) and is explicitly labeled as "notably above typical state volume." This combination suggests the provider is a regional hub for cardiac diagnostic services beyond basic ECGs.

The provider reports high throughput for ED‑level therapeutic and observation services: medications/infusion codes 96374 (51.4K claims, $874.3K revenue) and 96365 (27.2K claims, $870.1K revenue) and observation G0378 (5.9K claims, $1.5M revenue) reflect routine administration of IV therapies and use of observation care. Several of these administration codes are in the upper state percentiles (96374: rank #6 of 107, 95th percentile; 96365: 93th percentile), reinforcing that infusion and observation are operationally significant.

While many high‑volume codes are described as "typical, unremarkable" relative to in‑state peers, the provider shows specialty strengths where percentiles are notably elevated: physical therapy 97110 ranks #21 of 776 (97th percentile) and sleep study 95810 ranks #5 of 73 (94th percentile). These outlier percentiles identify specific ancillary areas—rehabilitation and sleep medicine—where the hospital is an above‑typical statewide provider.

SAINT JOSEPH's NPI was enumerated on 2005-06-21 (~21 years ago), indicating long tenure as a rural acute care hospital. Combined with the Medicaid‑dominant revenue base and concentrated service mix (ED visits, CT imaging, cardiac diagnostics, infusion/observation), the dataset portrays a long‑established community hospital that serves as a local acute and diagnostic hub with revenue and operational exposure concentrated in Medicaid and a handful of service lines.

Medicaid: Complete Services Breakdown

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

382 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.	46,280	$210	$9.6M
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.	13,050	$590	$7.7M
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.	26,410	$270	$7.2M
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.	43,810	$140	$6.2M
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	6,210	$540	$3.3M
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.	11,070	$270	$3M
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	7,800	$370	$2.9M
93005	The 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…	33,940	$50	$1.8M
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	7,610	$220	$1.6M
G0378	Hospital observation service, per hour	5,880	$260	$1.5M

Showing 1–10 of 382

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Saint Joseph Health System, Inc — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

382 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	25	280	7,150	$150	$3M
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.	30	240	4,710	$150	$2.6M
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.	19	280	5,700	$120	$2M
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.	19	180	1,870	$280	$1.5M
G0378	Hospital observation service, per hour	27	90	2,770	$190	$1.3M
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	15	30	2,320	$290	$1.2M
C1776	Joint device (implantable)	13	20	130	$2,890	$1.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	23	80	7,740	$30	$1.1M
C1713	Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)	10	40	550	$910	$1.1M
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	32	170	2,610	$250	$1M

Showing 1–10 of 382

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saint Joseph Health System, Inc	KY	General Acute Care Hospital	$0	$85.5M
Saint Joseph Health System, Inc	KY	General Acute Care Hospital	$0	$67.4M
Kentuckyone Health Medical Group, Inc.	KY	Family Medicine Physician	$0	$38.9M
Saint Joseph Health System, Inc	KY	General Acute Care Hospital	$0	$37.2M
Saint Joseph Health System, Inc	KY	Critical Access Hospital	$0	$29.8M
Robert Lavey	KY	Radiation Oncology Physician	$384.3K	$0
Emmanuel Nidhiry	KY	Medical Oncology Physician	$347.6K	$0
Nicola Jabbour	KY	Hematology & Oncology Physician	$195.8K	$0
Aman Khurana	IL	Internal Medicine Physician	$152.8K	$41.4K
Muhammad Niazi	KY	Hematology & Oncology Physician	$91.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Forever Care Dba Independent Opportunities	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$79M
Brock Medical, LLC	KY	Nurse Practitioner	$0	$63.5M
Recover Together, Inc.	KY	Adult Mental Health Clinic/Center	$0	$36.6M
Pinnacle Treatment Centers Ky-i, LLC	KY	Substance Abuse Rehabilitation Facility	$0	$33.5M
London Women's Care, LLC	KY	Obstetrics & Gynecology Physician	$0	$16M
Inspired Living	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$12M
Rrj Solutions, LLC	KY	Community/Behavioral Health Agency	$0	$8.6M
Cherished Care LLC	KY	Internal Medicine Physician	$0	$7M
Fuse Medical	KY	Nurse Practitioner	$0	$7M
New Hope Counseling And Recovery	KY	Mental Health Counselor	$0	$6.9M

Saint Joseph Health System, Inc — 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