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.

Center For Family Medicine (NPI 1164493672)

Field	Value
Entity Type	Organization
Organization	Center For Family Medicine
Address	1115 E 20th St
City	Sioux Falls
State	SD
ZIP	57105
Taxonomy	Family Medicine Physician
NPI Enumerated	February 1, 2006

Payer Source	Total Paid
Medicaid	$2.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

123 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…	16,340	$40	$686.4K
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…	6,820	$60	$388.9K
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…	3,270	$70	$216K
W0037	N/A	6,930	$20	$131.6K
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…	1,740	$70	$116.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,280	$70	$90.8K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	3,730	$20	$78.2K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	6,780	$10	$67.8K
90999	Use 90999 to report dialysis services or procedures that do not have a specific code.	3,940	$10	$55.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	660	$70	$48.2K

Showing 1–10 of 123

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

Center For Family Medicine — 2 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

123 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90999	Use 90999 to report dialysis services or procedures that do not have a specific code.	13	30	3,520	$50	$769.4K
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…	26	340	1,010	$100	$511K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	25	40	340	$90	$234.9K
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…	24	260	860	$80	$222.6K
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.	30	60	680	$60	$205.7K
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…	8	40	1,100	$80	$181.3K
90832	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…	40	70	200	$80	$176.7K
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…	24	70	400	$40	$172.5K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	39	60	120	$210	$171.2K
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.	44	70	1,150	$50	$155.9K

Showing 1–10 of 123

Related Providers

Other providers that share a Tax Identification Number (TIN) with Center For Family Medicine, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Garth Aasen	SD	Anatomic Pathology & Clinical Pathology Physician	$103.3K	$0
Shaina Riggs	SD	Family Medicine Physician	$31.2K	$0
James Wilde	SD	Family Medicine Physician	$11.1K	$0

Nearby Providers

Other providers in the same ZIP code as Center For Family Medicine, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
South Dakota Achieve	SD	Developmental Disabilities Clinic/Center	$0	$166.9M
Dakotabilities	SD	Voluntary or Charitable Agency	$0	$77.8M
Sanford Medical Center	SD	Family Medicine Physician	$0	$68.8M
Volunteers Of America, Dakotas	SD	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$60.9M
Southeastern Behavioral Healthcare	SD	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$59.1M
Resouces For Human Development, Inc.	SD	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$31.1M
Sanford Medical Center	SD	General Acute Care Hospital	$0	$24.4M
Childrens Dental Center	SD	Pediatric Dentistry	$0	$24M
Sanford Medical Center	SD	Air Ambulance	$0	$11.9M
Avera Mckennan	SD	Family Medicine Physician	$0	$10.6M

Center For Family Medicine — Billing Profile & Reimbursement Data

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Center For Family Medicine — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References