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.

South Lake Clinic, P.A. (NPI 1427027184)

Field	Value
Entity Type	Organization
Organization	South Lake Clinic, P.A.
Address	17705 Hutchins Dr
City	Minnetonka
State	MN
ZIP	55345
Taxonomy	Pediatrics Physician
NPI Enumerated	March 15, 2006

Payer Source	Total Paid
Medicaid	$5.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

61 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…	28,790	$50	$1.4M
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…	14,920	$70	$1.1M
S0302	Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)	27,320	$40	$1M
X5622	N/A	10,210	$50	$479.9K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	14,500	$20	$290K
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…	4,940	$60	$276.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	3,960	$60	$218K
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…	4,300	$50	$215.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1,690	$60	$104.8K
0241U	N/A	690	$140	$97.7K

Showing 1–10 of 61

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

South Lake Clinic, P.A. — 7 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

61 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1013	Sign language or oral interpretive services, per 15 minutes	154	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…	145	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…	75	1,200	1,030	$70	$549.7K
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	26	80	1,070	$90	$341.2K
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…	141	420	230	$90	$186.2K
S0302	Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)	11	310	810	$30	$166.5K
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…	26	240	610	$70	$165.5K
X5622	N/A	20	300	470	$60	$159.8K
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…	31	200	720	$60	$155.4K
98962	A nonphysician qualified healthcare professional uses a standard curriculum to educate a patient about their disease or disorder and how to manage it more effectively. This code represents each 30…	8	10	250	$90	$133.5K

Showing 1–10 of 61

Nearby Providers

Other providers in the same ZIP code as South Lake Clinic, P.A., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Autism Opportunities Foundation	MN	Psychologist	$0	$97M
North Memorial Health Care	MN	Primary Care Clinic/Center	$0	$7.4M
Minnetonka Public Schools	MN	Local Education Agency (LEA)	$0	$6.8M
Relate Inc	MN	Community/Behavioral Health Agency	$0	$6.3M
Grand St Paul Cvs LLC	MN	Pharmacy	$84.9K	$0
Amal Wasuge	MN	Occupational Therapist	$77K	$0
Claire Wheatley	MN	Physical Therapist	$56.5K	$0
Maria Ryan	MN	Sports Medicine (Family Medicine) Physician	$40.7K	$0
Andrew Cardinal	MN	Physical Therapist	$30.2K	$0

South Lake Clinic, P.A. — Billing Profile & Reimbursement Data

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South Lake Clinic, P.A. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References