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.

Woodrow Wilson Keeble Memorial Health Care Center (NPI 1366471666)

Field	Value
Entity Type	Organization
Organization	Woodrow Wilson Keeble Memorial Health Care Center
Address	100 Lake Traverse Drive
City	Sisseton
State	SD
ZIP	57262
Taxonomy	Clinic/Center
NPI Enumerated	July 1, 2006

Payer Source	Total Paid
Medicaid	$6.8M
Medicare	$0

Key Findings

This provider effectively operates as a Medicaid-focused clinic: there is no Medicare billing on file and lifetime Medicaid revenue is $6.8M, making Medicaid the sole reported payer driving documented revenue. The absence of Medicare billing indicates a single-payer footprint in the available claims data rather than a mixed Medicare/Medicaid practice profile.

Revenue is highly concentrated in a small set of office E/M codes: the precomputed top-3 Medicaid codes (99213, 99214, 99212) together account for 59.2% of this provider's total Medicaid revenue. Individually these top drivers are 99213 with $2.2M (33.7%), 99214 with $1.1M (16.5%), and 99212 with $585.6K (9.0%), showing that routine outpatient established-patient visits dominate billed dollars.

Clinical service lines implied by the code mix point to a primary ambulatory care clinic with an embedded dental program: the top revenue codes are office visits (99213/99214/99212) consistent with ongoing chronic and acute ambulatory care, while multiple dental codes (D0140, D0150, D1206, D0220, D1351, D7140) appear throughout the top services, indicating on‑site or closely integrated dental services. This combination suggests the organization provides comprehensive outpatient primary care plus a significant dental/preventive package to its Medicaid population.

Operational throughput is substantial in core visit volumes: 99213 appears on 5.1K claims and 99214 on 2.7K claims, which indicates steady, repeat outpatient utilization and likely sustained clinician and support‑staff demand to manage established‑patient panels. High claim counts for routine visits, together with frequent dental procedure claims such as 1.2K claims for D0140 and 1K claims for D0150, imply predictable daily clinical workflows across medical and dental services.

Preventive services and point-of-care procedures contribute meaningful secondary revenue: immunization code 90471 generated $230.5K (3.6% of Medicaid revenue) and COVID testing 87635 produced $41.3K (0.6%), while injection/therapeutic administration 96372 accounted for $61.6K (1.0%). These codes underscore active preventive care and in-clinic procedure capacity in addition to routine office visits.

State-level competitive standing is solid but not dominant: the provider ranks in the 79th percentile for 99213 (rank #73 of 344) and in the 79th percentile for 99214 (rank #55 of 260), with 99212 at the 81st percentile (rank #30 of 155), indicating above-average volume versus in-state peers but not market leadership. Several dental and ancillary codes are also high in-state — for example, D0150 ranks #12 of 108 (90th percentile) and D0220 ranks #13 of 87 (86th percentile) — which supports a characterization of the provider as a strong regional participant in both primary care and dental services rather than a statewide dominant provider.

Many of the top codes are described in the source data as having "typical, unremarkable volume for this code" despite high percentile placements, so these elevated rankings likely reflect consistent, reliable service lines rather than statistical outlier behavior. Examples include 99213, 99214, and numerous dental codes that, while generating concentrated revenue, are labeled in the underlying notes as typical volumes, suggesting steady, expected clinical activity rather than anomalous spikes.

The provider has long tenure in the NPI registry (NPI enumerated 2006-07-01 (~20 years ago)), which, combined with the concentrated Medicaid revenue base and sustained claim volumes (e.g., 5.1K claims for 99213), points to an established local presence and operational stability within the Medicaid market it serves. This longevity supports the interpretation that the observed code mix and revenue concentration reflect a persistent service model rather than a short-term reporting artifact.

Medicaid: Complete Services Breakdown

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

71 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…	5,070	$430	$2.2M
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…	2,740	$390	$1.1M
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,…	1,270	$460	$585.6K
D0140	Limited oral evaluation – problem focused	1,240	$370	$459.5K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	650	$480	$312.8K
D0150	Comprehensive oral evaluation – new or established patient	1,010	$290	$292.3K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	1,780	$150	$273K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	1,020	$230	$230.5K
W0037	N/A	4,570	$50	$205.7K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	270	$470	$125.2K

Showing 1–10 of 71

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

Woodrow Wilson Keeble Memorial Health Care Center — 0 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. South Dakota median

71 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…	73	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…	55	260	860	$80	$222.6K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	15	60	120	$210	$171.2K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	15	40	260	$90	$151.5K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	40	50	410	$80	$127.2K
D1351	Sealant - per tooth	12	50	400	$30	$117.3K
D2391	Resin‑based composite – one surface, posterior	24	40	150	$80	$115.5K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	44	70	130	$100	$99K
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,…	30	160	210	$120	$97.4K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	75	130	390	$90	$86.6K

Showing 1–10 of 71

Nearby Providers

Other providers in the same ZIP code as Woodrow Wilson Keeble Memorial Health Care Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Coteau Des Prairies Hospital	SD	Rural Health Clinic/Center	$0	$2.9M
Coteau Des Prairies Hospital	SD	Critical Access Hospital	$0	$2.3M
Royce Grimsrud	SD	Optometrist	$17.1K	$519.9K
Coteau Des Prairies Hospital	SD	Multi-Specialty Clinic/Center	$0	$438.4K
Community Transit, Inc	SD	Non-emergency Medical Transport (VAN)	$0	$215.5K
Sisseton School District 54 2	SD	Occupational Therapist	$0	$82.6K
John Weber Dds PLLC	SD	General Practice Dentistry	$0	$50.6K
Chukwuemeka Ekeke	SD	General Practice Physician	$2.8K	$39.8K
Jasmine Hypolite	SD	Psychiatric/Mental Health Nurse Practitioner	$22.1K	$0
Stanley Gallagher	SD	Family Medicine Physician	$18.8K	$0

Woodrow Wilson Keeble Memorial Health Care Center — Billing Profile & Reimbursement Data

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Woodrow Wilson Keeble Memorial Health Care 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

Nearby Providers

Frequently Asked Questions

References