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

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

Thedacare, Incorporated (NPI 1376656959)

Thedacare, Incorporated is a family medicine physician provider located in New London, Wisconsin. This profile covers 0 Medicare and 144 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	Thedacare, Incorporated
Address	1405 Mill St
City	New London
State	WI
ZIP	54961
Taxonomy	Family Medicine Physician
NPI Enumerated	August 16, 2006

Payer Source	Total Paid
Medicaid	$14.8M
Medicare	$0

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

144 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…	157,790	$40	$6.3M
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…	186,510	$30	$5.4M
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	8,160	$50	$367.3K
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…	13,030	$20	$273.7K
99391	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…	4,100	$60	$237.7K
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…	3,740	$60	$216.7K
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.	7,930	$20	$174.5K
99204	The provider sees a new 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 provider…	2,590	$60	$160.3K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	5,260	$30	$152.4K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	4,370	$30	$135.4K

Showing 1–10 of 144

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wisconsin Distribution

Thedacare, Incorporated — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

144 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0585	Injection, onabotulinumtoxina, 1 unit	27	30	550	$240	$428.8K
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…	9	1,630	270	$40	$205.3K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	107	120	400	$180	$186.8K
J2315	Injection, naltrexone, depot form, 1 mg	6	10	190	$430	$184.1K
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…	7	1,760	250	$40	$173.2K
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.	329	350	300	$50	$157.9K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	18	150	440	$70	$131.9K
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	102	220	2,770	$20	$120.2K
99391	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…	28	190	370	$60	$107.4K
78815	PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.…	20	20	160	$200	$102.5K

Showing 1–10 of 144

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Thedacare Medical Center - Shawano, Inc.	WI	Critical Access Hospital	$0	$32.8M
Thedacare Regional Medical Center-neenah, Inc.	WI	General Acute Care Hospital	$0	$18.3M
Thedacare Regional Medical Center - Appleton, Inc.	WI	General Acute Care Hospital	$0	$11.5M
Thedacare Medical Center - Waupaca, Inc.	WI	Critical Access Hospital	$0	$10.9M
Thedacare Medical Center - Berlin, Inc.	WI	Critical Access Hospital	$0	$9.4M
Thedacare Medical Center - New London, Inc.	WI	Critical Access Hospital	$0	$9.2M
Thedacare, Incorporated	WI	Community Based Hospice Care Agency	$0	$8.3M
Thedacare, Incorporated	WI	Durable Medical Equipment & Medical Supplies	$0	$7.4M
Thedacare Medical Center - Wild Rose, Inc	WI	Critical Access Hospital	$0	$6M
Thedacare, Incorporated	WI	Counselor	$0	$1.5M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jacob Kream	WI	Emergency Medicine Physician	$51.9K	$5K
Tori Beyer	WI	Family Nurse Practitioner	$28.1K	$0
Molly Benck	WI	Optometrist	$25K	$0
Craig Sylte	WI	Optometrist	$18.6K	$0
Joseph Lamb	WI	Family Medicine Physician	$13.2K	$0

Thedacare, Incorporated — Billing Profile & Reimbursement Data

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Thedacare, Incorporated — 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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