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

Why is the Medicaid comparison limited to North Dakota 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. North Dakota (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.

Plains Medical Clinic, LLC (NPI 1073698460)

Field	Value
Entity Type	Organization
Organization	Plains Medical Clinic, LLC
Address	3290 20th St S
City	Fargo
State	ND
ZIP	58104
Taxonomy	Family Medicine Physician
NPI Enumerated	October 26, 2006

Payer Source	Total Paid
Medicaid	$249.8K
Medicare	$0

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	3,200	$50	$143.8K
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…	1,280	$40	$56.4K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	430	$60	$27.3K
99203	The provider sees a new 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 provider…	170	$90	$16.3K
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…	100	$50	$5.2K
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,…	40	$30	$950
X5622	N/A	10	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Dakota Distribution

Plains Medical Clinic, LLC — 0 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Dakota

Full comparison — all codes billed, vs. North Dakota median

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	56	210	360	$100	$498.2K
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…	114	170	300	$100	$415.8K
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,…	45	60	130	$190	$242.5K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	5	10	170	$80	$85.3K
99203	The provider sees a new 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 provider…	12	30	90	$60	$69.3K
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	2	10	270	$50	$51.1K
X5622	N/A	4	10	890	$30	$35.4K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Plains Medical Clinic, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hoadley Harris	ND	Family Medicine Physician	$81K	$0

Nearby Providers

Other providers in the same ZIP code as Plains Medical Clinic, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pediatric Therapy Partners, Inc.	ND	Early Intervention Provider Agency	$0	$7M
Marina Gilca	ND	Retina Specialist (Ophthalmology) Physician	$4.3M	$0
Fargo Maple View LLC	ND	Alzheimer Center (Dementia Center)	$0	$4M
Beyond Boundaries Occupational Therapy, Inc.	ND	Multi-Specialty Clinic/Center	$0	$3.9M
Max Johnson	ND	Retina Specialist (Ophthalmology) Physician	$2.8M	$0
St. Sophie's, LLC	ND	Adolescent and Children Mental Health Clinic/Center	$0	$2.7M
Shangri-la Home Care	ND	Home Health Agency	$0	$2M
Beyond Boundaries Speech Language Therapy, Inc.	ND	Speech-Language Pathologist	$0	$2M
About Smiles Dental, LLC	ND	Dental Clinic/Center	$0	$1.7M
Center For Pain Medicine Surgery Center LLC	ND	Ambulatory Surgical Clinic/Center	$1.2M	$0

Plains Medical Clinic, LLC — Billing Profile & Reimbursement Data

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Plains Medical Clinic, LLC — Billing Profile & Reimbursement Data

Sign up for Plains Medical Clinic, LLC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References