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.

Centracare Clinic (NPI 1407858020)

Centracare Clinic is a multi-specialty clinic/center provider located in Saint Cloud, Minnesota. This profile covers 0 Medicare and 67 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	Centracare Clinic
Address	1900 Centracare Cir
City	Saint Cloud
State	MN
ZIP	56303
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	August 12, 2005

Payer Source	Total Paid
Medicaid	$6.9M
Medicare	$0

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

67 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…	60,290	$60	$3.3M
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…	33,360	$70	$2.5M
99203	The provider sees a new 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 provider…	6,080	$70	$431.4K
G0108	Diabetes outpatient self-management training services, individual, per 30 minutes	4,070	$60	$227.9K
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…	1,120	$100	$115.3K
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…	980	$110	$105.4K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	2,640	$20	$42.2K
95251	A provider analyzes and interprets data from a patient’s continuous glucose monitor (CGM) and writes a report based on interpretation. This code represents the professional component of the service…	1,730	$20	$34.5K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	250	$90	$23.2K
T1013	Sign language or oral interpretive services, per 15 minutes	620	$30	$19.7K

Showing 1–10 of 67

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

Centracare Clinic — 2 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

67 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1013	Sign language or oral interpretive services, per 15 minutes	100	210	560	$60	$822.1K
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…	56	1,180	1,150	$80	$605.7K
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…	30	1,200	1,030	$70	$549.7K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	185	270	550	$70	$254.7K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	9	20	110	$240	$253.2K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	12	20	220	$190	$189.2K
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…	95	420	230	$90	$186.2K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	88	90	380	$100	$185.4K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	118	160	110	$50	$172.2K
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.	16	40	100	$140	$148.2K

Showing 1–10 of 67

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Centracare Clinic	MN	Multi-Specialty Clinic/Center	$0	$20.8M
Centracare Clinic	MN	Multi-Specialty Clinic/Center	$0	$19.3M
Centracare Health System - Long Prairie	MN	Rural Health Clinic/Center	$0	$6.9M
Centracare Clinic	MN	Primary Care Clinic/Center	$0	$6.1M
Joseph Wang	NY	Radiation Oncology Physician	$607.9K	$0
David Kruse	CA	Sports Medicine (Family Medicine) Physician	$442.6K	$0
Leah Thronaum	MN	Neurology Physician	$369.7K	$0
Rachel Schuneman	MN	Dermatology Physician	$256.4K	$0
Abigail Taylor	MN	Internal Medicine Physician	$249.6K	$0
Kathleen Rieke	MN	Neurology Physician	$229.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Cloud Hospital	MN	General Acute Care Hospital	$0	$53.4M
Central Minnesota Mental Health Center	MN	Mental Health Counselor	$0	$36.2M
Eye Kraft Optical, Inc	MN	Eyewear Supplier	$0	$17.7M
Northway Academy, Inc.	MN	Developmental Disabilities Clinic/Center	$0	$14.4M
Koala Dental Care, LLC	MN	Pediatric Dentistry	$0	$11.3M
Centracare Health Systems	MN	Clinical Medical Laboratory	$1.2M	$9.4M
Centracare Health System	MN	Clinical Medical Laboratory	$345.1K	$9.1M
St. Cloud Area School District 742	MN	Local Education Agency (LEA)	$0	$9.3M
Kozy Transport Services, Inc	MN	Non-emergency Medical Transport (VAN)	$0	$6.3M
St Cloud Outpatient Surgery Ltd	MN	Ambulatory Surgical Clinic/Center	$2.1M	$4M

Centracare Clinic — 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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