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.

Sanford Clinic (NPI 1174537799)

Field	Value
Entity Type	Organization
Organization	Sanford Clinic
Address	1309 W 17th St Ste G01
City	Sioux Falls
State	SD
ZIP	57104
Taxonomy	Radiation Oncology Physician
NPI Enumerated	July 28, 2006

Payer Source	Total Paid
Medicaid	$70.9K
Medicare	$0

Medicaid: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	630	$60	$38.1K
77063	The provider captures three dimensional images of the breast using X–rays at various angles for routine checkup. He checks for the presence of any abnormality within the breasts. Tomosynthesis…	630	$40	$24.1K
76642	In this procedure, the provider performs a focused ultrasound of one breast on a limited area. The procedure includes documentation of the images.	120	$50	$6.3K
77066	The provider performs X–ray imaging on both breasts in a patient with a lump or suspected cancer and may use specially designed computer software to help identify or diagnose potential abnormalities…	20	$50	$940
G0279	Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)	180	$10	$920
77065	The provider performs X–ray imaging on one breast in a patient with a known lump or suspected cancer and may use specially designed computer software to help identify or diagnose potential…	20	$40	$560

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

Sanford Clinic — 1 of 6 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

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	6	20	120	$50	$27.4K
76642	In this procedure, the provider performs a focused ultrasound of one breast on a limited area. The procedure includes documentation of the images.	5	10	220	$40	$20.3K
77063	The provider captures three dimensional images of the breast using X–rays at various angles for routine checkup. He checks for the presence of any abnormality within the breasts. Tomosynthesis…	4	20	120	$30	$10.3K
77066	The provider performs X–ray imaging on both breasts in a patient with a lump or suspected cancer and may use specially designed computer software to help identify or diagnose potential abnormalities…	5	10	30	$40	$5.2K
77065	The provider performs X–ray imaging on one breast in a patient with a known lump or suspected cancer and may use specially designed computer software to help identify or diagnose potential…	4	10	50	$40	$2.7K
G0279	Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)	1	10	160	$10	$870

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sanford Medical Center	SD	Family Medicine Physician	$0	$68.8M
Sanford Health Network	MN	Rural Acute Care Hospital	$0	$7.6M
Sanford Health Network	IA	Family Medicine Physician	$0	$6.6M
Sanford Clinic	SD	Diagnostic Radiology Physician	$0	$6M
Sanford Clinic	SD	Pediatrics Physician	$0	$5.5M
Sanford Health Network	SD	General Acute Care Hospital	$0	$4.4M
Sanford Clinic	SD	Hospitalist Physician	$0	$2.9M
Willamette Orthopedic Group LLC	OR	Orthopaedic Surgery Physician	$0	$2.7M
Sanford Clinic	SD	Family Medicine Physician	$0	$2M
Gustavo Westin	FL	Medical Oncology Physician	$2M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sanford Medical Center	SD	Clinical Medical Laboratory	$1.8M	$18M
Lutheran Social Services Of Sd	SD	Psychiatric Residential Treatment Facility	$0	$15.7M
Iwe Inc.	SD	In Home Supportive Care Agency	$0	$15M
City Of Sioux Falls	SD	Federally Qualified Health Center (FQHC)	$0	$8.6M
South Dakota Home Care, Inc.	SD	Respite Care	$0	$8.6M
Paramedics Logistics South Dakota LLC	SD	Land Ambulance	$1.9M	$3.6M
Sanford Healthcare Accessories, LLC	SD	Durable Medical Equipment & Medical Supplies	$0	$3.1M
Behavior Care Specialists, Inc	SD	Behavior Analyst	$0	$2.9M
Asana Integrated Medical Group PC	SD	Psychiatry Physician	$0	$2.5M
Rehabilitation Medical Supply	SD	Durable Medical Equipment & Medical Supplies	$0	$2.1M

Sanford Clinic — Billing Profile & Reimbursement Data

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Sanford Clinic — 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