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.

Aspirus Medford Hospital & Clinics, Inc. (NPI 1427140649)

Aspirus Medford Hospital & Clinics, Inc. is a rural health clinic/center provider located in Medford, Wisconsin. This profile covers 0 Medicare and 39 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	Aspirus Medford Hospital & Clinics, Inc.
Address	143 S Gibson St
City	Medford
State	WI
ZIP	54451
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	September 28, 2006

Payer Source	Total Paid
Medicaid	$1.8M
Medicare	$0

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

39 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…	15,300	$50	$734.5K
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…	16,490	$30	$544.1K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	3,700	$80	$280.8K
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…	1,240	$50	$64.5K
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…	1,190	$50	$61.8K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	630	$50	$31.6K
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.	2,340	$10	$25.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	350	$50	$19K
76817	The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.	500	$40	$19K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	1,830	$10	$14.6K

Showing 1–10 of 39

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

Aspirus Medford Hospital & Clinics, Inc. — 1 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

39 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	85	1,630	270	$40	$205.3K
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…	81	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.	67	350	300	$50	$157.9K
88175	The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer…	36	40	3,060	$20	$147.8K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	108	900	410	$70	$130.4K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	739	790	400	$40	$109.6K
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…	61	190	370	$60	$107.4K
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…	62	210	340	$60	$98.9K
87624	The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result.	69	70	500	$30	$95.6K
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,…	541	690	160	$60	$90.4K

Showing 1–10 of 39

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Aspirus Medford Hospital & Clinics, Inc.	WI	Critical Access Hospital	$0	$11.8M
Deepak Sambhara	WI	Ophthalmology Physician	$4.3M	$0
Eric Berkowitz	NY	Vascular & Interventional Radiology Physician	$2.6M	$1.2M
David Filsoof	CA	Cardiovascular Disease Physician	$1.3M	$0
Mckenzie County Healthcare Systems Inc	ND	Critical Access Hospital	$0	$1.2M
Mathew Aschbrenner	WI	Ophthalmology Physician	$919.8K	$0
Ammar Taha	WI	Diagnostic Radiology Physician	$410.5K	$380K
Sean Whalen	NY	Nuclear Medicine Physician	$555.5K	$0
Maxwell Wingelaar	WI	Ophthalmology Physician	$446.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
North Central Region Ccs Program	WI	Community/Behavioral Health Agency	$0	$2.7M
Family Health Center Of Marshfield Inc	WI	Federally Qualified Health Center (FQHC)	$0	$2.3M
Medford School District	WI	Local Education Agency (LEA)	$0	$1.3M
Kelsey Brost	WI	Physician Assistant	$46.7K	$0
Samuel Klinner	WI	Chiropractor	$17.6K	$2.2K
Angela Guden	WI	Certified Registered Nurse Anesthetist	$15.5K	$0

Aspirus Medford Hospital & Clinics, Inc. — Billing Profile & Reimbursement Data

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Aspirus Medford Hospital & Clinics, Inc. — 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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