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

Why is the Medicaid comparison limited to South 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. South 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.

Radiology Associates Prof, LLC (NPI 1093772527)

Key Findings

Field	Value
Entity Type	Organization
Organization	Radiology Associates Prof, LLC
Address	2929 5th St.
City	Rapid City
State	SD
ZIP	57701
Taxonomy	Diagnostic Radiology Physician
NPI Enumerated	April 27, 2006

Payer Source	Total Paid
Medicaid	$5.3M
Medicare	$0

RADIOLOGY ASSOCIATES PROF, LLC is effectively a Medicaid-focused imaging provider: there is no Medicare billing on file and reported lifetime Medicaid revenue is $5.3M. The firm's top three Medicaid CPT codes account for 38.2% of its Medicaid revenue, indicating concentrated reliance on a small set of high-volume imaging procedures.

The practice’s service mix is CT- and image-guidance–centric: the top three revenue-driving Medicaid codes are 74177 (CT abdomen/pelvis with contrast), 70450 (CT head without contrast), and 71275 (CT angiography of the chest), and these three alone make up 38.2% of Medicaid revenue. Additional claims activity across ultrasound (e.g., 76805, 76705), MRI (70551/70553), mammography (77067), and image-guided procedures such as 49083 (paracentesis with imaging guidance) points to a full-service outpatient diagnostic radiology operation rather than a narrow subspecialty clinic.

Revenue concentration is pronounced: 74177 accounts for 17.3% of Medicaid revenue (10.5K claims, $758.6K revenue), 70450 accounts for 11.2% (11.7K claims, $490.4K revenue), and 71275 accounts for 9.8% (3.6K claims, $429.2K revenue). That precomputed 38.2% share from the top three codes underscores how pivotal CT imaging is to the practice’s Medicaid revenue base.

State-level competitive standing for core CT exams is strong: 74177 ranks #2 of 19 providers in-state (94th percentile; notably above typical state volume for this code), 70450 ranks #2 of 21 (95th percentile; notably above typical state volume for this code), and 71275 ranks #2 of 10 (89th percentile; notably above typical state volume for this code). These rank/percentile positions indicate the provider is a major in-state performer for high-volume CT services.

The provider holds outright statewide leadership for several niche or resource-intensive codes: for example, 49083 ranks #1 of 4 providers (100th percentile; typical, unremarkable volume for this code), 74176 ranks #1 of 11 (100th percentile; notably above typical state volume for this code), 71260 ranks #1 of 8 (100th percentile; notably above typical state volume for this code), and 77067 ranks #1 of 15 (100th percentile; notably above typical state volume for this code). These #1 rankings—across paracentesis with image guidance, noncontrast abdominal CT, thoracic CT with contrast, and mammography—suggest the practice has particular operational strengths in both diagnostic and image-guided procedural lines.

The practice is an outlier in plain throughput metrics for basic radiography and CT: it reported 32.8K claims for 71045 and 20K claims for 71046, with 71046 specifically characterized as an "extreme outlier, far above typical state volume for this code." High claim counts on these chest X-ray codes alongside large CT volumes imply significant patient throughput and capacity for high-volume, routine imaging workflows.

Being enumerated since 2006-04-27 (~20 years ago) indicates long tenure in the market; combined with sustained, high-volume Medicaid billing and multiple top-in-state ranks, this profile is consistent with an established regional imaging provider with entrenched referral relationships. The longevity plus concentrated Medicaid revenue suggests stability but also exposure to Medicaid-specific reimbursement dynamics given the absence of Medicare billing.

Medicaid: Complete Services Breakdown

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

109 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	10,540	$70	$758.6K
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.	11,680	$40	$490.4K
71275	In this procedure, the provider performs a computed tomographic angiography, or CTA imaging of the chest to get detailed images of the blood vessels but not the heart. He performs this study using a…	3,580	$120	$429.2K
49083	In this procedure, the provider withdraws an abnormal buildup of fluid from the abdominal cavity to relieve pressure and pain or to obtain a sample to submit to a laboratory for analysis. He…	1,850	$150	$274.9K
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	4,120	$70	$271.8K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	32,780	$10	$196.7K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	1,050	$170	$181.1K
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.	3,810	$40	$167.5K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	20,000	$10	$160K
71260	In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the thorax using contrast material.	2,710	$60	$159.7K

Showing 1–10 of 109

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Dakota Distribution

Radiology Associates Prof, LLC — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

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

109 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	3	10	1,550	$190	$259.7K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	5	10	670	$40	$165.4K
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.	2	20	100	$70	$140K
49083	In this procedure, the provider withdraws an abnormal buildup of fluid from the abdominal cavity to relieve pressure and pain or to obtain a sample to submit to a laboratory for analysis. He…	1	10	590	$160	$123.4K
71275	In this procedure, the provider performs a computed tomographic angiography, or CTA imaging of the chest to get detailed images of the blood vessels but not the heart. He performs this study using a…	2	10	50	$120	$119.9K
70551	The provider uses magnetic resonance imaging, or MRI, to examine the brain and brain stem. The provider does not administer contrast for this exam.	2	10	1,180	$100	$112.1K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	7	20	260	$40	$90.3K
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	20	140	$40	$78.1K
93975	The provider performs a complete study of the abdominal, pelvic, scrotal, and or retroperitoneal organs using duplex ultrasound. He performs the procedure to examine the vascular supply to the organs…	2	10	1,240	$60	$64.4K
70486	The provider uses computed tomography, or CT, to examine the maxillofacial area, such as the upper jaw or face structures. The provider does not administer contrast for this exam.	2	10	660	$90	$60.5K

Showing 1–10 of 109

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Behavior Management Systems, Inc.	SD	Community/Behavioral Health Agency	$0	$19.8M
Monument Health Rapid City Hospital, Inc	SD	Multi-Specialty Clinic/Center	$0	$18.7M
Monument Health Rapid City Hospital, Inc.	SD	General Acute Care Hospital	$0	$11.5M
Community Health Center Of The Black Hills Inc	SD	Federally Qualified Health Center (FQHC)	$0	$10.2M
Jrk Services, Inc	SD	Home Health Agency	$0	$10.1M
Black Hills Pediatrics, LLP	SD	Pediatrics Physician	$0	$9.7M
Rapid City Emergency Services PA	SD	Emergency Medicine Physician	$0	$8.2M
Wellspring Inc.	SD	Psychiatry Physician	$0	$7.4M
Prema Abraham	SD	Retina Specialist (Ophthalmology) Physician	$7.1M	$0
Monument Health Rapid City Hospital, Inc.	SD	Multi-Specialty Clinic/Center	$0	$5.2M

Radiology Associates Prof, LLC — Billing Profile & Reimbursement Data

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Radiology Associates Prof, LLC — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Thomas Reher	SD	Diagnostic Radiology Physician	$540.8K	$0
Leo Flynn	SD	Diagnostic Radiology Physician	$457K	$0
Jena Kumar	SD	Diagnostic Radiology Physician	$327.1K	$0
David White	SD	Diagnostic Radiology Physician	$291.1K	$0
Joel Brink	NE	Diagnostic Radiology Physician	$285.8K	$0
Neil Kumar	SD	Diagnostic Radiology Physician	$281K	$0
Roland Holcomb	MN	Diagnostic Radiology Physician	$271.5K	$0
William Schenk	MT	Diagnostic Radiology Physician	$216.5K	$0
David Plunkett	NV	Diagnostic Radiology Physician	$185.8K	$12.3K
Matthew Hustrulid	SD	Diagnostic Radiology Physician	$184.4K	$0