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.

Susan Fanta (NPI 1326049313)

Field	Value
Entity Type	Individual
Organization	Susan Fanta
Address	1104 W 8th St
City	Yankton
State	SD
ZIP	57078
Taxonomy	Internal Medicine Physician
NPI Enumerated	August 2, 2005

Payer Source	Total Paid
Medicare	$323.6K
Medicaid	$0

Key Findings

Provider is effectively single‑payer: all lifetime public payer revenue is Medicare ($323.6K) and there is no Medicaid billing on file, so analyses of payer mix should treat this practice as Medicare‑focused rather than dual‑payer. The NPI was enumerated 2005-08-02 (∼21 years ago), indicating an established billing history with Medicare.

Revenue is highly concentrated in a small set of outpatient evaluation and management and preventive codes: the top three Medicare codes (99214, G0439, 99213) account for 48.2% of total Medicare revenue. Individually those codes generate $72.7K (25.0%), $35.9K (12.3%), and $31.6K (10.9%) respectively, which means nearly half of the provider’s Medicare dollars come from routine office visits and annual wellness services.

The code mix identifies a primary care / outpatient chronic care operation: high volume in 99214 (865 claims, $84 avg paid/claim, $72.7K revenue), 99213 (575 claims, $55 avg paid/claim, $31.6K revenue), and strong use of annual wellness visits with G0439 (287 claims, $125 avg paid/claim, $35.9K revenue). This pattern — mid‑to‑high complexity E/M visits plus AWV utilization — is consistent with ongoing management of chronic disease, preventive care delivery, and longitudinal primary care relationships.

Competitive standing on core primary‑care services is strong: 99214 ranks in the 97th percentile nationally and is described as "notably above typical national volume", while G0439 and 99213 are both in the 95th percentile and also labeled "notably above typical national volume". Those percentiles indicate this provider delivers a higher visit volume for those codes than most peers nationally, even though overall Medicare revenue ($323.6K) is modest in absolute terms.

The practice provides onsite procedural and ancillary services that support a full primary‑care workflow: 36415 (venipuncture) shows 1K claims and $8K revenue and is characterized as "typical, unremarkable volume for this code", while common preventive services such as pneumococcal vaccine 90677 (43 claims, $281 avg paid/claim, $12.1K revenue) and influenza vaccination codes (90662 and G0008) also appear in the top codes. This mix supports point‑of‑care vaccination and routine lab work as part of office visits.

Imaging and diagnostic services contribute meaningfully but are not dominant: screening mammography 77067 (243 claims, $127 avg paid/claim, $30.9K revenue) and tomosynthesis 77063 (243 claims, $52 avg paid/claim, $12.6K revenue) are present alongside CT and ultrasound entries, but these imaging codes are described as having typical or unremarkable volumes relative to peers. That suggests referral or local access to imaging, with the practice capturing some imaging revenue but not operating as a major radiology center.

There is a notable presence of medication administration and care‑transition billing: J0897 (denosumab injection) appears with 1K claims and $18.4K revenue but is labeled "typical, unremarkable volume for this code" and ranks in the lower national percentiles, indicating the provider administers this medication repeatedly yet at a lower volume compared with specialist practices that focus on bone‑health therapeutics. Transitional care management 99495 (46 claims, $158 avg paid/claim, $7.3K revenue) ranks in the 94th percentile, showing comparatively high use of post‑discharge follow‑up services for Medicare patients.

Implication for business strategy and contracting: with 48.2% of Medicare revenue tied to three ambulatory E/M and AWV codes, the practice’s financial performance is sensitive to visit volume and preventive care uptake. Given the absence of Medicaid revenue and the provider’s elevated national percentiles on core E/M and AWV codes, value arrangements or network strategies that reward primary‑care visit continuity, AWV completion, and care‑transition management would align closely with the existing service mix.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

76 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	870	$80	$72.7K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	290	$130	$35.9K
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…	580	$60	$31.6K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	240	$130	$30.9K
J0897	Injection, denosumab, 1 mg	1,020	$20	$18.4K
77063	The provider captures three dimensional images of the breast using X–rays at various angles for routine checkup. He checks for the presence of any abnormality within the breasts. Tomosynthesis…	240	$50	$12.6K
90677	This code represents a vaccine product administered intramuscularly to protect against pneumococcal disease, a bacterial infection. This is a 20–valent vaccine, protecting against 20 strains of the…	40	$280	$12.1K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	1,000	$10	$8K
90662	This code represents a flu vaccine product that is a split virus type, contains no preservatives, and has enhanced effectiveness due to a higher antigen content. It is administered as an injection…	110	$70	$7.7K
99495	The provider manages the care of a patient during the transition to home care after discharge from a healthcare facility. The patient’s care requires at least moderate medical decision making,…	50	$160	$7.3K

Showing 1–10 of 76

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 76 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Dakota Distribution

Susan Fanta — 7 of 25 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. state median

76 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0897	37	40	2,460	$20	$52.8K
93306	56	60	250	$50	$21.4K
77067	36	120	70	$50	$13.1K
99214	23	1,660	90	$70	$11.4K
G0439	8	240	60	$120	$10.9K
74177	70	80	90	$70	$10K
17000	82	100	200	$30	$8.5K
90677	15	110	20	$280	$7.7K
77063	35	110	70	$30	$7.5K
99215	248	450	40	$100	$7.5K

Showing 1–10 of 76

Related Providers

Other providers that share a Tax Identification Number (TIN) with Susan Fanta, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Yankton Medical Clinic PC	SD	Internal Medicine Physician	$0	$6.3M
Chad Laurich	SD	Vascular Surgery Physician	$3.2M	$0
NPI 1588636484	—	—	$3.2M	$0
Ryan Geraets	SD	Ophthalmology Physician	$3M	$0
John Bormes	SD	Ophthalmology Physician	$2.6M	$0
Elizabeth Atchison	SD	Ophthalmology Physician	$1.7M	$0
Ashar Luqman	IA	Nephrology Physician	$1.4M	$0
Taylor Slingsby	SD	Retina Specialist (Ophthalmology) Physician	$1.4M	$0
Ty Hanson	SD	Dermatology Physician	$1.2M	$0
Alexander Ringeisen	MN	Retina Specialist (Ophthalmology) Physician	$1.1M	$0

Nearby Providers

Other providers in the same ZIP code as Susan Fanta, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ability Building Services, Inc.	SD	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$39.2M
Lewis & Clark Behavioral Health Services, Inc.	SD	Community/Behavioral Health Agency	$0	$24M
Yankton Ph	SD	Assisted Living Facility (Mental Illness)	$0	$4.1M
Cedar Vilage Assisted Living Center	SD	Assisted Living Facility (Mental Illness)	$0	$2.4M
Heartland Psychological Services	SD	Psychiatry Physician	$0	$1.3M
Avera At Home	SD	Home Health Agency	$0	$1M
Sacred Heart Health Services	SD	Rural Acute Care Hospital	$0	$942.8K
Mary Lee Villanueva	SD	Hematology & Oncology Physician	$788.7K	$0
Sacred Heart Health Services	SD	Emergency Care Clinic/Center	$0	$766.6K
Kore Cares In Home Services, LLC	SD	In Home Supportive Care Agency	$0	$700.6K

Susan Fanta — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References