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.

Presentation Medical Center (NPI 1265404958)

Key Findings

Field	Value
Entity Type	Organization
Organization	Presentation Medical Center
Address	213 2nd Ave Ne
City	Rolla
State	ND
ZIP	58367
Taxonomy	Critical Access Hospital
NPI Enumerated	February 6, 2006

Payer Source	Total Paid
Medicaid	$8.8M
Medicare	$0

This provider has no Medicare billing on file and reports $8.8M in lifetime Medicaid revenue, making its publicly visible fee-for-service activity effectively single-payer (Medicaid) in scale. Analysts should treat PRESENTATION MEDICAL CENTER as predominantly Medicaid-reimbursed for payer-mix comparisons and benchmarking.

Revenue is highly concentrated in three emergency department E/M codes: 99284 ($3M, 34.0%), 99283 ($2.5M, 28.3%), and 99282 ($2.4M, 27.1%); these top three codes account for 89.4% of the provider’s total Medicaid revenue. This concentration indicates that nearly all Medicaid dollars are driven by ED encounters rather than routine outpatient or inpatient procedures.

The code mix — dominated by 99282–99284 — points to an operational focus on emergency department evaluation and management, with large volumes of relatively low- to moderate-acuity ED visits. Supporting services such as injections and point-of-care testing (for example, 96372 at 2.5K claims, $221.8K revenue and 87880 at 1.7K claims, $35K revenue) indicate on-site therapeutic administration and rapid diagnostics are part of typical ED workflows.

PRESENTATION MEDICAL CENTER is a statewide volume leader for 99282, ranking #1 of 28 providers in-state (100th percentile; extreme outlier), and a high-volume performer for 99283 (#6 of 48, 89th percentile). By contrast, 99284 is more typical in-state (#9 of 33, 75th percentile), so the provider’s competitive strength is concentrated in lower-acuity ED visits rather than the highest-acuity E/M encounters.

Diagnostic and laboratory services are present but represent small shares of total Medicaid revenue: 80053 (2.4K claims, $59.5K, 0.7%), 85025 (3.7K claims, $51.3K, 0.6%), and chest x-ray 71046 (707 claims, $40.3K, 0.5%). These volumes suggest a functional in-house diagnostic capability that supports ED throughput but does not meaningfully diversify revenue away from ED E/M services.

Use of parenteral therapy is notable: 96372 shows 2.5K claims and $221.8K revenue (2.5%) and ranks #2 of 32 in-state (97th percentile; notably above typical state volume). Additional IV/infusion codes such as 96374 (214 claims, $17.5K) and 96361 (73 claims, $8.4K) are present at much lower volumes, signaling episodic but meaningful medication administration within the ED.

Office and outpatient evaluation codes and ancillary therapy produce comparatively small revenue lines — for example, 99213 accounts for 247 claims and $29.4K (0.3%) and ranks #113 of 206 in-state (45th percentile), while 97110 physical therapy is 230 claims and $24.4K (0.3%). This pattern reinforces that outpatient clinic services are a secondary revenue source relative to ED activity.

The provider’s NPI was enumerated on 2006-02-06 (~20 years ago), indicating an established presence in its market. Combined with an ED-centric Medicaid revenue profile and lack of Medicare billing, the data are consistent with a long-standing critical access hospital operating primarily as a Medicaid-focused emergency access point in its community.

Medicaid: Complete Services Breakdown

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

53 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	9,620	$310	$3M
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.	11,350	$220	$2.5M
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.	15,660	$150	$2.4M
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	2,460	$90	$221.8K
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.	240	$800	$190.2K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	2,380	$30	$59.5K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	3,660	$10	$51.3K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	710	$60	$40.3K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	8,760	$1	$35K
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.	1,750	$20	$35K

Showing 1–10 of 53

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

Presentation Medical Center — 6 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

53 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.	14	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.	9	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.	6	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…	113	210	360	$100	$498.2K
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.	1	30	450	$110	$198.3K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	11	10	1,400	$50	$172.8K
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.	9	10	630	$150	$148.3K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	3	10	60	$70	$144.2K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	17	30	360	$30	$94.6K
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	6	10	300	$50	$53.7K

Showing 1–10 of 53

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Presentation Medical Center	ND	Clinic/Center	$0	$1.7M
Tyson Williams	ND	Podiatrist	$122.2K	$0
Adam Nicholson	ND	Urology Physician	$119.3K	$0
Cordell Davis	ND	Urology Physician	$100.5K	$0
Yara Cameron	ND	Interventional Cardiology Physician	$95.6K	$0
Hans Joseph	ND	Orthopaedic Surgery Physician	$63.3K	$0
Vanessa Sundeen	ND	Family Nurse Practitioner	$55.4K	$0
Anne Nygaard	ND	Family Nurse Practitioner	$44.6K	$0
Kamrin Macki	ND	Nurse Practitioner	$29.6K	$0
Anatolie Usatii	ND	Surgery Physician	$28.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Commmunity Ambulance Service, Inc	ND	Land Ambulance	$240.6K	$2.5M
Rolette County Public Health	ND	Public Health or Welfare Agency	$95K	$1.3M
Tri-care Home Health Inc	ND	Home Health Agency	$0	$213.8K
Turner Dental Office PC	ND	General Practice Dentistry	$0	$94.1K
Luke Weston Dds PLLC	ND	Dental Clinic/Center	$0	$91.6K
Lavonne Charbonneau	ND	Physician Assistant	$6.9K	$0

Presentation 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