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

Why is the Medicaid comparison limited to North 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. North 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.

St. Alexius Medical Center (NPI 1205868429)

Key Findings

Field	Value
Entity Type	Organization
Organization	St. Alexius Medical Center
Address	900 E Broadway Ave
City	Bismarck
State	ND
ZIP	58501
Taxonomy	Specialist
NPI Enumerated	July 7, 2006

Payer Source	Total Paid
Medicaid	$3.6M
Medicare	$0

This provider is effectively a Medicaid-only billing entity: total Medicaid revenue is $3.6M and there is none (no Medicare billing on file). The absence of Medicare activity means Medicaid dominates the provider’s public-payer exposure and risk profile, concentrating revenue and performance benchmarking against in-state Medicaid peers rather than national Medicare peers.

Revenue is highly concentrated in a small number of evaluation-and-management codes: the top three Medicaid codes (99214, 99213, 99232) together account for 60.4% of the provider’s Medicaid revenue. Individually these are 99214 (9.5K claims, $930.1K revenue, 26.2%), 99213 (11.2K claims, $671.3K revenue, 18.9%), and 99232 (9.2K claims, $541.6K revenue, 15.3%), indicating that routine established outpatient visits and subsequent inpatient follow-ups are the primary revenue drivers.

The code mix points to a combined outpatient and inpatient service-line focus: high volumes of 99214 and 99213 signal substantial ambulatory follow-up/primary-specialty clinic activity, while 99232 and other inpatient E/M codes (99233, 99231, 99222, 99223) show significant inpatient/observation care throughput. Complementary procedure and diagnostic codes—93306 (echocardiography), 93010 (ECG interpretation), CT and radiography codes—support a hospital-based or full-service clinic model that provides diagnostics alongside E/M encounters.

Competitive standing for the big ambulatory codes is relatively strong by rank: 99214 ranks #12 of 171 providers in-state and 99213 ranks #13 of 206 providers in-state, both at the 94th percentile. The dataset characterizes these volumes as "typical, unremarkable volume for this code," which suggests high absolute placement within the state but not an anomalous or outlier billing pattern relative to peers.

For inpatient subsequent care, 99232 ranks #6 of 26 in-state at the 80th percentile, described as "typical, unremarkable volume for this code," indicating the provider is a solid, above-average participant in post-admission management but not necessarily the dominant statewide provider for that service. Other inpatient initial and discharge codes (e.g., 99223, 99222, 99239) appear with moderate revenue shares, reinforcing consistent inpatient activity.

The provider shows limited engagement with the highest-acuity ED visits: 99285 is present but ranks #16 of 19 providers in-state at the 17th percentile and is labeled "typical, unremarkable volume for this code." This pattern suggests emergency care is part of the service mix but that the facility handles fewer high-complexity ED cases relative to many in-state peers.

Behavioral health and procedural/diagnostic ancillary lines contribute meaningful but secondary revenue: psychotherapy 90834 ($171.9K, 4.8%) and psychiatric evaluation 90791 ($19.1K, 0.5%) indicate an active behavioral-health component, while 93306 (echocardiography, $118.3K, 3.3%) and imaging codes (e.g., 71045, 71046, 74177) point to on-site diagnostics supporting clinical care. Smaller procedure codes such as anesthesia 00170 (613 claims, $72.3K, 2.0%) and spine injection 62323 show additional specialty services that diversify revenue beyond core E/M.

The NPI was enumerated on 2006-07-07 (~20 years ago), indicating a long-established presence in the Bismarck market. That tenure, combined with concentrated Medicaid revenue and above-average in-state ranks for top outpatient codes, frames this entity as a stable, Medicaid-focused clinical provider with multiple ancillary services rather than a Medicare-focused or narrowly specialized operation.

Medicaid: Complete Services Breakdown

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

58 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	9,490	$100	$930.1K
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…	11,190	$60	$671.3K
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…	9,180	$60	$541.6K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	1,420	$120	$173K
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…	2,200	$80	$171.9K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	2,080	$60	$118.3K
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.	1,020	$110	$114.1K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	13,010	$10	$91.1K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	1,450	$60	$88.6K
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…	590	$150	$86.1K

Showing 1–10 of 58

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Dakota Distribution

St. Alexius Medical Center — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Dakota

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

58 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	16	20	1,120	$220	$2M
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.	18	30	1,280	$180	$1.4M
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.	28	50	670	$150	$829.9K
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…	13	210	360	$100	$498.2K
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…	6	30	460	$50	$423.5K
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…	12	170	300	$100	$415.8K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	6	20	310	$70	$364K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	7	10	310	$150	$323.5K
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,…	30	60	130	$190	$242.5K
62323	The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the lumbar (lower back) or sacral (caudal, or tailbone)…	6	10	660	$320	$235.6K

Showing 1–10 of 58

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Winona Health Services	MN	General Acute Care Hospital	$0	$13.4M
St. Alexius Medical Center	ND	General Acute Care Hospital	$0	$3.5M
Mid Dakota Clinic, Inc.	ND	Clinic/Center	$0	$2.9M
Ryan Ramaekers	NE	Hematology & Oncology Physician	$2.1M	$0
Robert Reynolds	ND	Radiation Oncology Physician	$1.4M	$0
Rohit Kapoor	TX	Hematology & Oncology Physician	$1.2M	$0
Joseph Rosen	AZ	Medical Oncology Physician	$978.5K	$0
Cole Kreofsky	ND	Radiation Oncology Physician	$959K	$0
St. Alexius Medical Center	ND	Durable Medical Equipment & Medical Supplies	$0	$824.9K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Enable, Inc.	ND	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$40.8M
Heartview Foundation	ND	Substance Use Disorder Rehabilitation Clinic/Center	$0	$13.6M
Sanford Bismarck	ND	General Acute Care Hospital	$0	$12.5M
Bismarck Public Schools Early Intervention	ND	Early Intervention Provider Agency	$0	$12M
West Central Behavioral Health Clinic	ND	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.2M
D. Michael Goebel D.d.s., PC	ND	Pediatric Dentistry	$0	$5.8M
Poppy's Promise LLC	ND	Community/Behavioral Health Agency	$0	$5.6M
Sanford Bismarck	ND	Clinical Medical Laboratory	$726.9K	$4.3M
Lasting Love Homecare	ND	In Home Supportive Care Agency	$0	$3.6M
Sanford Bismarck	ND	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3.5M

St. Alexius Medical Center — 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