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 1306832654)

St. Alexius Medical Center is a general acute care hospital provider located in Bismarck, North Dakota. This profile covers 0 Medicare and 92 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	St. Alexius Medical Center
Address	900 E Broadway Ave
City	Bismarck
State	ND
ZIP	58501
Taxonomy	General Acute Care Hospital
NPI Enumerated	September 22, 2005

Payer Source	Total Paid
Medicaid	$3.5M
Medicare	$0

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

92 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.	6,500	$230	$1.5M
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.	7,060	$180	$1.2M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	1,800	$130	$231.8K
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.	1,090	$120	$132.6K
G0330	Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an…	120	$750	$90.5K
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.	700	$90	$61.4K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	2,060	$20	$43.3K
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.	210	$190	$39.2K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	540	$60	$31.7K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	1,410	$20	$25.4K

Showing 1–10 of 92

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 — 3 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

92 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	7	10	4,940	$60	$2.3M
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.	17	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.	13	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.	16	50	670	$150	$829.9K
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…	149	170	300	$100	$415.8K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	32	70	1,950	$60	$387K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	51	60	1,860	$60	$348.7K
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.	10	30	450	$110	$198.3K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	16	20	1,200	$50	$190.6K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	7	10	1,400	$50	$172.8K

Showing 1–10 of 92

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	Specialist	$0	$3.6M
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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St. Alexius Medical 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

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