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

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

Riverton Memorial Hospital LLC (NPI 1245337286)

Key Findings

Field	Value
Entity Type	Organization
Organization	Riverton Memorial Hospital LLC
Address	1320 Bishop Randall Dr
City	Lander
State	WY
ZIP	82520
Taxonomy	Rural Acute Care Hospital
NPI Enumerated	September 20, 2006

Payer Source	Total Paid
Medicaid	$4.7M
Medicare	$0

RIVERTON MEMORIAL HOSPITAL LLC is effectively a Medicaid-focused provider: there is no Medicare billing on file and its lifetime Medicaid revenue is reported as $4.7M, so analyses of utilization and competitive position should be viewed through a single-payer (Medicaid) lens rather than a mixed Medicare/Medicaid footprint. The provider’s NPI was enumerated on 2006-09-20 (~20 years ago), indicating long-tenured participation in federal payer programs despite the current absence of Medicare claims.

Revenue concentration is extreme: the precomputed top three Medicaid codes (99283, 99284, 41899) account for 93.9% of this provider’s total Medicaid revenue. Those three codes are large line items by dollar amount — 99283 generated $1.9M (40.8% of total Medicaid revenue), 99284 generated $1.6M (34.8%), and 41899 generated $848.9K (18.2%) — so any payer negotiations or utilization-management efforts should prioritize these specific services.

The clinical mix is dominated by emergency department evaluation-and-management activity: 99283 (low MDM ED visit) and 99284 (moderate MDM ED visit) are the top two revenue drivers, together representing the single largest source of Medicaid revenue. 99283 alone is $1.9M and 99284 is $1.6M, and both codes’ descriptions point to high ED visit volumes and throughput as the core operational driver of the hospital’s outpatient revenue.

Competitive standing within the state is concentrated and, for some codes, dominant. The provider ranks #1 of 34 for 99283 (100th percentile; labeled an extreme outlier), indicating it is a statewide leader in billed low-level ED E/M visits. For 99284 it ranks #3 of 25 (92th percentile; notably above typical state volume), making it a top-tier provider for moderate-complexity ED visits as well.

The dental/oral surgery-related code 41899 is the third major revenue contributor at $848.9K (18.2% of Medicaid revenue) and ranks #2 of 8 in-state (86th percentile; described as typical). This pattern suggests the facility also bills a substantial amount for dental or oral-alveolar procedures that do not have a more specific code, representing a material outpatient service line beyond core ED E/M work.

Infusion and medication-administration services appear as secondary but measurable revenue lines: 96374 (rapid IV push) produced $190.1K (4.1% of total) with 3.2K claims and ranks #1 of 7 in-state (100th percentile; typical), while other infusion codes such as 96361, 96365, and 96375 appear at much lower dollar levels. These entries are consistent with an ED and outpatient operational model that includes frequent IV medication and hydration treatments.

Claims-volume and lab-testing patterns are notable for very high counts paired with $0 avg paid/claim in Medicaid data. Examples include 85025 (17K claims, $0 avg paid/claim; rank #2 of 31, 97th percentile) and 80053 (14.2K claims, $0 avg paid/claim; rank #2 of 31, 97th percentile), as well as several other lab codes (81001, 83690, 83735, 87804) showing top-percentile claim volumes with no recorded Medicaid-paid revenue. This suggests a reporting or reimbursement configuration where laboratory services are present in claims data at high volume but not reflected as standalone Medicaid-paid dollars (e.g., bundled billing or outside-lab arrangements), and it is an important caveat for revenue-per-service benchmarking.

Beyond the top three codes, Medicaid-paid dollars drop off quickly: many listed codes contribute only small amounts (for example, 96374 at $190.1K, 96361 at $23.1K, and U0001 at $2.6K). Given that the top three codes account for 93.9% of Medicaid revenue, the provider’s financial exposure and utilization patterns are highly concentrated in a few services, so program changes, utilization-management policies, or competitive shifts affecting ED visits or outpatient dental procedures would disproportionately impact overall Medicaid revenue.

Medicaid: Complete Services Breakdown

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

47 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	18,290	$100	$1.9M
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.	12,100	$130	$1.6M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	710	$1,190	$848.9K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	3,170	$60	$190.1K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	960	$20	$23.1K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	650	$20	$15.5K
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.	190	$80	$14.9K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	780	$20	$14.1K
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	510	$10	$7.1K
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.	110	$60	$6.9K

Showing 1–10 of 47

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wyoming Distribution

Riverton Memorial Hospital LLC — 4 of 19 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wyoming

Full comparison — all codes billed, vs. Wyoming median

47 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	2	10	110	$1,770	$828.4K
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.	3	30	1,430	$110	$429.5K
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.	9	20	240	$110	$395K
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.	1	30	610	$90	$246.9K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	1	10	320	$60	$84.7K
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.	12	20	110	$60	$54.1K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	10	10	120	$30	$21.3K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	2	10	100	$40	$19.2K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	7	20	500	$10	$15.2K
99281	The provider sees a patient for the lowest level emergency department visit.	2	10	30	$80	$12.7K

Showing 1–10 of 47

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Allan Wicks	WY	Cardiovascular Disease Physician	$370.6K	$0
Adrian Fluture	WY	Cardiovascular Disease Physician	$322.1K	$0
John Pickrell	WY	Cardiovascular Disease Physician	$309.4K	$0
Clinton Mcmahill	WY	Internal Medicine Physician	$227.5K	$0
Ghazi Ghanem	WY	Infectious Disease Physician	$215.6K	$0
Cory Lamblin	WY	Orthopaedic Surgery Physician	$156K	$0
Anthony Lowham	WY	Surgery Physician	$38.8K	$0
Gregory Clifford	WY	Emergency Medicine Physician	$35.6K	$0
Gentian Scheer	WY	Internal Medicine Physician	$33.9K	$0
Kari Sack	WY	Certified Registered Nurse Anesthetist	$11.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Health Center Of Central Wyoming Inc	WY	Federally Qualified Health Center (FQHC)	$0	$2.8M
Frontier Wyoming, L.L.C.	WY	Home Health Agency	$0	$2.5M
Lander Medical Clinic, PC	WY	Family Medicine Physician	$0	$2.1M
Eh Health Home Health Of The Northwest, LLC	WY	Home Health Agency	$0	$2M
Gregory P Clifford Md PC	WY	Personal Emergency Response Attendant	$0	$1.8M
Guardian Flight LLC	WY	Air Ambulance	$699K	$586.5K
Jessica West	WY	Case Manager/Care Coordinator	$0	$964.6K
Knell Access Management	WY	In Home Supportive Care Agency	$0	$893.6K
Wyoming Path Behavioral Health, LLC	WY	Community/Behavioral Health Agency	$0	$836.8K
Fremont County Pediatric Clinic	WY	Pediatrics Physician	$0	$629.4K

Riverton Memorial Hospital LLC — 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