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

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

Centracare Clinic (NPI 1043212665)

Centracare Clinic is a multi-specialty clinic/center provider located in St Cloud, Minnesota. This profile covers 0 Medicare and 122 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	Centracare Clinic
Address	1200 Sixth Ave No
City	St Cloud
State	MN
ZIP	56303
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	August 12, 2005

Payer Source	Total Paid
Medicaid	$19.3M
Medicare	$0

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

122 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	41,940	$60	$2.4M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	45,610	$50	$2.1M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	61,360	$30	$2M
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	19,350	$90	$1.7M
J0585	Injection, onabotulinumtoxina, 1 unit	3,160	$420	$1.3M
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…	7,780	$120	$926.1K
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…	22,720	$40	$863.5K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	15,370	$50	$753.2K
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…	19,430	$40	$679.9K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	5,870	$90	$528.1K

Showing 1–10 of 122

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Minnesota Distribution

Centracare Clinic — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. Minnesota median

122 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1013	Sign language or oral interpretive services, per 15 minutes	124	210	560	$60	$822.1K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	11	120	400	$60	$685.8K
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…	10	50	310	$130	$678K
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…	37	1,180	1,150	$80	$605.7K
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…	123	1,200	1,030	$70	$549.7K
J0585	Injection, onabotulinumtoxina, 1 unit	2	20	350	$560	$492.3K
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	6	20	60	$960	$469.8K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	6	100	250	$100	$399.5K
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	5	10	560	$260	$336.5K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	7	170	620	$40	$333K

Showing 1–10 of 122

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Centracare Clinic	MN	Multi-Specialty Clinic/Center	$0	$20.8M
Centracare Clinic	MN	Multi-Specialty Clinic/Center	$0	$6.9M
Centracare Health System - Long Prairie	MN	Rural Health Clinic/Center	$0	$6.9M
Centracare Clinic	MN	Primary Care Clinic/Center	$0	$6.1M
Joseph Wang	NY	Radiation Oncology Physician	$607.9K	$0
David Kruse	CA	Sports Medicine (Family Medicine) Physician	$442.6K	$0
Leah Thronaum	MN	Neurology Physician	$369.7K	$0
Rachel Schuneman	MN	Dermatology Physician	$256.4K	$0
Abigail Taylor	MN	Internal Medicine Physician	$249.6K	$0
Kathleen Rieke	MN	Neurology Physician	$229.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Cloud Hospital	MN	General Acute Care Hospital	$0	$53.4M
Central Minnesota Mental Health Center	MN	Mental Health Counselor	$0	$36.2M
Eye Kraft Optical, Inc	MN	Eyewear Supplier	$0	$17.7M
Northway Academy, Inc.	MN	Developmental Disabilities Clinic/Center	$0	$14.4M
Koala Dental Care, LLC	MN	Pediatric Dentistry	$0	$11.3M
Centracare Health Systems	MN	Clinical Medical Laboratory	$1.2M	$9.4M
Centracare Health System	MN	Clinical Medical Laboratory	$345.1K	$9.1M
St. Cloud Area School District 742	MN	Local Education Agency (LEA)	$0	$9.3M
Kozy Transport Services, Inc	MN	Non-emergency Medical Transport (VAN)	$0	$6.3M
St Cloud Outpatient Surgery Ltd	MN	Ambulatory Surgical Clinic/Center	$2.1M	$4M

Centracare Clinic — 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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