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

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

Northern Lights Health LLC (NPI 1316581440)

Northern Lights Health LLC is a primary care nurse practitioner provider located in Waconia, Minnesota. This profile covers 0 Medicare and 30 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	Northern Lights Health LLC
Address	212 W Lake St
City	Waconia
State	MN
ZIP	55387
Taxonomy	Primary Care Nurse Practitioner
NPI Enumerated	October 31, 2019

Payer Source	Total Paid
Medicaid	$7.6M
Medicare	$0

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

30 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
Q4186	Epifix, per square centimeter (add-on, list separately in addition to primary procedure)	2,210	$2,600	$5.7M
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	22,740	$40	$977.9K
99489	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	2,520	$110	$264.9K
99487	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	2,770	$60	$163.3K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	2,420	$30	$82.4K
15271	The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the patient’s trunk, arms, and/or legs up to an area of 100 cm2. This code covers up to the first 25 cm2.	1,370	$50	$71.3K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	940	$60	$51.6K
11043	The provider uses surgical instruments to remove the dead tissue in muscle and/or fascia, including any debridement of the epidermis, dermis, and subcutaneous tissue, for the first or only 20 cm2 or…	660	$80	$50.1K
99305	The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	540	$60	$31.6K
99306	The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves high medical decision making, and/or the provider spends at least…	270	$80	$23K

Showing 1–10 of 30

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Minnesota Distribution

Northern Lights Health LLC — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. Minnesota median

30 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
Q4186	Epifix, per square centimeter (add-on, list separately in addition to primary procedure)	1	10	2,210	$2,600	$5.7M
99310	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends…	29	40	510	$60	$295.8K
99349	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	18	40	250	$80	$235.8K
99336	N/A	17	30	210	$50	$207.3K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	9	100	590	$40	$202.6K
99489	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	1	10	1,610	$90	$137.8K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	10	40	390	$130	$109.8K
99306	The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves high medical decision making, and/or the provider spends at least…	10	20	270	$80	$84.7K
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…	6	20	70	$250	$63.6K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	542	560	2,600	$10	$62.5K

Showing 1–10 of 30

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nicole Siddons	MN	Family Nurse Practitioner	$1.1M	$0
Judy Pauletich	MN	Adult Health Nurse Practitioner	$1M	$0
Tiffany Radke	MN	Acute Care Nurse Practitioner	$628.8K	$0
Melissa Hill	MN	Family Nurse Practitioner	$619K	$0
Holly Girdeen	WI	Primary Care Nurse Practitioner	$184.5K	$0
Jackie Yang	MN	Nurse Practitioner	$78.9K	$0
Michael Helfman	MN	Gerontology Nurse Practitioner	$58.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ridgeview Medical Center	MN	General Acute Care Hospital	$0	$19.6M
Sunnydays Therapy Inc	MN	Occupational Therapist	$0	$10.6M
Carver County	MN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$7.8M
Ridgeview Medical Center	MN	Diagnostic Radiology Physician	$0	$7.1M
Waconia Ops. LLC	MN	Assisted Living Facility	$0	$4.7M
Stephanie Childs	MN	Radiation Oncology Physician	$714.6K	$0
Christopher Meyer	MN	Sports Medicine (Orthopaedic Surgery) Physician	$187.4K	$0
Kamruz Darabi	MN	Dermatology Physician	$162K	$0
Todd Holcomb	MN	Internal Medicine Physician	$122.3K	$0
Amanda Lane	MN	Occupational Therapist	$112.4K	$0

Northern Lights Health LLC — Billing Profile & Reimbursement Data

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Northern Lights Health LLC — 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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