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.

Flandreau Santee Sioux Tribe (NPI 1437188729)

Flandreau Santee Sioux Tribe is a adult day care clinic/center provider located in Flandreau, South Dakota. This profile covers 0 Medicare and 47 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	Flandreau Santee Sioux Tribe
Address	403 W Broad Ave
City	Flandreau
State	SD
ZIP	57028
Taxonomy	Adult Day Care Clinic/Center
NPI Enumerated	July 1, 2006

Payer Source	Total Paid
Medicaid	$2.9M
Medicare	$0

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

47 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…	2,740	$470	$1.3M
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…	830	$500	$410K
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,…	780	$480	$372.2K
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…	220	$620	$133.1K
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…	200	$570	$111.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	330	$320	$106.9K
90832	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…	180	$570	$102.4K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	360	$220	$77.9K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	260	$270	$68.9K
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.	80	$510	$37.9K

Showing 1–10 of 47

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

Flandreau Santee Sioux Tribe — 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

47 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…	102	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…	132	260	860	$80	$222.6K
90832	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…	39	70	200	$80	$176.7K
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.	36	60	120	$210	$171.2K
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…	169	190	430	$90	$154.1K
42700	The provider uses an incision to drain an abscess next to one of the tonsils.	3	10	60	$350	$138.1K
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,…	41	160	210	$120	$97.4K
D2392	Post 2 surface resin‑based composite	56	60	100	$100	$89.5K
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…	82	130	390	$90	$86.6K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	47	110	990	$20	$82.9K

Showing 1–10 of 47

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kara Perrelli	NE	Diagnostic Radiology Physician	$284.5K	$0
Gregory Peters	NE	Diagnostic Radiology Physician	$167.4K	$0
Jason Grennan	NE	Diagnostic Radiology Physician	$157K	$3.3K
Christopher Koch	TN	Diagnostic Radiology Physician	$132.7K	$360
Mohammed Quraishi	NE	Diagnostic Radiology Physician	$104K	$3.2K
Jonathan Jaksha	NE	Diagnostic Radiology Physician	$104.1K	$2.9K
Steven Mccormack	NE	Diagnostic Radiology Physician	$79.7K	$0
Allison Summers	NE	Diagnostic Radiology Physician	$43.2K	$0
Forrest Anshutz	SD	Physical Therapist	$31.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Avera Mckennan	SD	Rural Health Clinic/Center	$0	$394.1K
Flandreau School District #50-3	SD	Local Education Agency (LEA)	$0	$202.8K
County Of Moody	SD	Land Ambulance	$126.1K	$1.9K
Avera Mckennan	SD	Critical Access Hospital	$0	$52.8K
Abbie Entringer	SD	Family Nurse Practitioner	$8.3K	$0
Scott Peterson	SD	Family Medicine Physician	$540	$0

Flandreau Santee Sioux Tribe — Billing Profile & Reimbursement Data

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Flandreau Santee Sioux Tribe — 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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