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

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

Grand River Hospital District (NPI 1124074042)

Grand River Hospital District is a rural health clinic/center provider located in Rifle, Colorado. This profile covers 0 Medicare and 50 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	Grand River Hospital District
Address	501 Airport Rd
City	Rifle
State	CO
ZIP	81650
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	May 25, 2006

Payer Source	Total Paid
Medicaid	$14M
Medicare	$0

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

50 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	24,880	$260	$6.5M
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…	18,970	$180	$3.4M
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	6,350	$170	$1.1M
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,…	2,240	$310	$688.9K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	2,690	$190	$496.9K
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…	3,520	$130	$447.4K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,350	$230	$311.2K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	790	$330	$263.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	580	$340	$199K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	420	$290	$120.8K

Showing 1–10 of 50

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Grand River Hospital District — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

50 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	236	290	1,390	$110	$958.7K
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.	234	270	1,290	$100	$937.1K
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…	80	2,520	330	$100	$352K
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…	93	2,630	430	$90	$268.2K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	913	1,670	550	$100	$229.3K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	83	130	280	$130	$228.2K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	105	240	550	$110	$208.5K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	74	260	380	$100	$161.6K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	28	590	200	$80	$119.9K
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,…	66	690	140	$90	$118.4K

Showing 1–10 of 50

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grand River Hospital District	CO	Rural Health Clinic/Center	$0	$4.9M
Grand River Hospital District	CO	Critical Access Hospital	$0	$3.6M
Garrett Caputo	CO	Emergency Medicine Physician	$283.8K	$0
Messina Michalsky	MT	Psychiatric/Mental Health Nurse Practitioner	$12.3K	$256.5K
Michael Duehrssen	NE	Emergency Medicine Physician	$243.8K	$0
Kelly Thomas	CO	Dermatology Physician	$195.3K	$0
Dolores Snell	CO	Medical Physician Assistant	$177.6K	$0
Behzad Molavi	CO	Interventional Cardiology Physician	$132.2K	$0
Qaisar Khan	CO	Interventional Cardiology Physician	$102.3K	$0
Justin Knight	CO	Emergency Medicine Physician	$85.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mountain Family Health Centers	CO	Federally Qualified Health Center (FQHC)	$0	$7.4M
Colorado River Fire Rescue	CO	Land Ambulance	$182.8K	$358.8K
Event Medical Solutions Unlimited PLLC	CO	Ambulance	$164.7K	$0
Eileen Daly	CO	Emergency Medicine Physician	$91.2K	$0

Grand River Hospital District — Billing Profile & Reimbursement Data

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Grand River Hospital District — 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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