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.

Monument Health Network, Inc. (NPI 1215458211)

Field	Value
Entity Type	Organization
Organization	Monument Health Network, Inc.
Address	1100 Highway 71 S Ste 101
City	Hot Springs
State	SD
ZIP	57747
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	June 29, 2017

Payer Source	Total Paid
Medicaid	$324.1K
Medicare	$0

Medicaid: Complete Services Breakdown

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

10 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…	2,140	$70	$152.1K
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…	1,620	$80	$123.1K
W0037	N/A	1,180	$30	$34.1K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	140	$60	$9.2K
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…	30	$90	$2.6K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	40	$40	$1.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	10	$100	$1.2K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	10	$20	$230
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	20	$10	$120
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	50	$1	$50

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

Monument Health Network, Inc. — 0 of 10 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

10 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…	116	340	1,010	$100	$511K
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…	92	260	860	$80	$222.6K
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…	61	70	130	$100	$99K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	93	110	990	$20	$82.9K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	92	160	180	$40	$59.6K
W0037	N/A	68	160	690	$20	$50.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	63	70	110	$110	$42.9K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	81	80	210	$30	$18K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	113	130	110	$10	$6.9K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	7	20	30	$20	$750

Nearby Providers

Other providers in the same ZIP code as Monument Health Network, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Fall River Health Services	SD	Rural Health Clinic/Center	$0	$1.4M
Hot Springs Ambulance Service	SD	Land Ambulance	$264.2K	$53.5K
Fall River Health Services	SD	Critical Access Hospital	$0	$303.3K
Wilkinson Vision, Inc	SD	Optometrist	$0	$195.2K
Cascade Chiropractic Of South Dakota	SD	Chiropractor	$0	$147.1K
Massa Dental Offices, PC	SD	General Practice Dentistry	$0	$132.3K
Dallas Wilkinson	SD	Optometrist	$70.1K	$0
Catherine Wilson	SD	Certified Registered Nurse Anesthetist	$52.1K	$0
Brad Fischer	SD	Physical Therapist	$51.9K	$0
Shannon Deboer	SD	Chiropractor	$50.1K	$0

Monument Health Network, Inc. — Billing Profile & Reimbursement Data

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Monument Health Network, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References