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

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

Tri-state Physicians & Physical Therapy Clinic PC (NPI 1114180767)

Tri-state Physicians & Physical Therapy Clinic PC is a chiropractor provider located in South Sioux City, Nebraska. This profile covers 0 Medicare and 13 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	Tri-state Physicians & Physical Therapy Clinic PC
Address	3900 Dakota Ave Ste 6
City	South Sioux City
State	NE
ZIP	68776
Taxonomy	Chiropractor
NPI Enumerated	July 3, 2008

Payer Source	Total Paid
Medicaid	$1.4M
Medicare	$0

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
98941	The provider applies manipulation to influence joint and neurophysiological function by a variety of techniques and modalities in three to four spinal regions.	31,710	$20	$729.3K
98940	The provider applies manipulation to influence joint and neurophysiological function by a variety of techniques and modalities in one to two spinal regions.	13,110	$30	$340.9K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	6,730	$30	$201.8K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	4,520	$20	$76.8K
72100	The technician takes 2 or 3 views of the vertebrae in the lumbar region which is the lower part of the spine and the sacrum, the area that connects the spine to the pelvis. Lumbosacral spine X–rays…	1,120	$30	$32.5K
97012	Mechanical traction is a highly successful alternative to surgery. Techniques applied in mechanical traction are dependent on the patient's condition, disorder, tolerance level, and the spinal level…	1,560	$10	$17.2K
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	320	$50	$15.7K
72040	The patient has a 2– or 3–view X–ray of the neck vertebrae.	140	$30	$3.5K
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…	100	$30	$2.8K
97014	The provider, who is typically a physical therapist, applies an electrical current to nerves or to a muscle or group of muscles, causing them to contract. It is used to restore function to a body…	150	$20	$2.3K

Showing 1–10 of 13

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nebraska Distribution

Tri-state Physicians & Physical Therapy Clinic PC — 2 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nebraska

Full comparison — all codes billed, vs. Nebraska median

13 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…	533	700	660	$70	$305.1K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	26	210	660	$40	$122.6K
98941	The provider applies manipulation to influence joint and neurophysiological function by a variety of techniques and modalities in three to four spinal regions.	2	240	1,180	$30	$69.2K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	13	80	190	$30	$47.9K
98940	The provider applies manipulation to influence joint and neurophysiological function by a variety of techniques and modalities in one to two spinal regions.	2	130	530	$30	$45.7K
97012	Mechanical traction is a highly successful alternative to surgery. Techniques applied in mechanical traction are dependent on the patient's condition, disorder, tolerance level, and the spinal level…	20	60	700	$20	$35.5K
97014	The provider, who is typically a physical therapist, applies an electrical current to nerves or to a muscle or group of muscles, causing them to contract. It is used to restore function to a body…	24	30	400	$10	$33.6K
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	16	50	70	$30	$17.9K
72100	The technician takes 2 or 3 views of the vertebrae in the lumbar region which is the lower part of the spine and the sacrum, the area that connects the spine to the pelvis. Lumbosacral spine X–rays…	5	30	70	$20	$9.9K
72040	The patient has a 2– or 3–view X–ray of the neck vertebrae.	6	20	120	$30	$7K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Heartland Counseling Services, Inc.	NE	Community/Behavioral Health Agency	$0	$2.3M
Siouxland Dental Health - South Sioux, LLC	NE	General Practice Dentistry	$0	$1.8M
Riverview Surgical Center LLC	NE	Ambulatory Surgical Clinic/Center	$1.7M	$0
Mercy Medical Services	NE	Family Medicine Physician	$0	$1.1M
Drs. Kincaid And Fett	NE	Eyewear Supplier	$0	$683.8K
Community Rehab LLC	NE	Physical Therapist	$0	$524.7K
Spenser Morton	NE	Ophthalmology Physician	$375.7K	$0
Michael Hattan	NE	Family Medicine Physician	$115.9K	$0
David Ensz	NE	Family Medicine Physician	$115.9K	$0
Michael Brenner	NE	Family Medicine Physician	$94.6K	$0

Tri-state Physicians & Physical Therapy Clinic PC — Billing Profile & Reimbursement Data

Sign up for Tri-state Physicians & Physical Therapy Clinic PC — Billing Profile & Reimbursement Data policy alerts

Tri-state Physicians & Physical Therapy Clinic PC — Billing Profile & Reimbursement Data

Sign up for Tri-state Physicians & Physical Therapy Clinic PC — 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