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.

St Benedict Health Center (NPI 1295758266)

Field	Value
Entity Type	Organization
Organization	St Benedict Health Center
Address	401 W Glynn Dr
City	Parkston
State	SD
ZIP	57366
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	July 25, 2006

Payer Source	Total Paid
Medicaid	$616.6K
Medicare	$0

Medicaid: Complete Services Breakdown

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

18 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…	5,340	$80	$405.5K
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…	1,260	$80	$95.9K
W0037	N/A	1,960	$20	$45K
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,…	470	$60	$29.3K
99348	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves low medical decision making or the provider spends at least 30…	350	$50	$16.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	70	$110	$7.3K
90832	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…	60	$90	$5K
G0444	Annual depression screening, 5 to 15 minutes	340	$10	$2.8K
99347	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves straightforward medical decision making or the provider spends at…	70	$40	$2.6K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	120	$20	$2K

Showing 1–10 of 18

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

St Benedict Health Center — 3 of 15 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

18 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…	69	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…	111	260	860	$80	$222.6K
90832	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…	59	70	200	$80	$176.7K
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,…	56	160	210	$120	$97.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	55	60	170	$90	$66.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	94	160	180	$40	$59.6K
W0037	N/A	51	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.	41	70	110	$110	$42.9K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	66	70	450	$20	$29.2K
99347	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves straightforward medical decision making or the provider spends at…	2	10	550	$20	$11.4K

Showing 1–10 of 18

Related Providers

Other providers that share a Tax Identification Number (TIN) with St Benedict Health Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Benedict Health Center	SD	Rural Health Clinic/Center	$0	$885.8K
David Arend	SD	Urology Physician	$181.9K	$0
Bruce Watt	SD	Cardiovascular Disease Physician	$93.7K	$0
St Benedict Health Center	SD	Critical Access Hospital	$0	$41.6K
Arthur Moeller	MI	Facial Plastic Surgery Physician	$31.1K	$0
Leland Murren	NE	Certified Registered Nurse Anesthetist	$14.7K	$0
Ashleigh Eilts	SD	Family Nurse Practitioner	$8K	$0
Kendra Baily	SD	Audiologist	$6.2K	$0
Cody Freudenthal	ND	Certified Registered Nurse Anesthetist	$4.5K	$0
Janice Gerlach	SD	Psychiatry Physician	$3.7K	$0

St Benedict Health Center — Billing Profile & Reimbursement Data

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St Benedict Health Center — 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

Frequently Asked Questions

References