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.

Avera St. Luke's (NPI 1437346681)

Field	Value
Entity Type	Organization
Organization	Avera St. Luke's
Address	310 S Penn St Ste 203
City	Aberdeen
State	SD
ZIP	57401
Taxonomy	Cardiovascular Disease Physician
NPI Enumerated	October 2, 2007

Payer Source	Total Paid
Medicaid	$50K
Medicare	$0

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	770	$40	$26.9K
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…	400	$30	$11.2K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	2,760	$1	$11K
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…	50	$20	$770
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	20	$1	$70

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

Avera St. Luke's — 0 of 5 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

5 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…	295	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…	165	260	860	$80	$222.6K
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…	7	20	90	$60	$82.3K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	9	50	310	$10	$14.3K
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	34	40	260	$1	$900

Related Providers

Other providers that share a Tax Identification Number (TIN) with Avera St. Luke's, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Avera St. Luke's	SD	Family Medicine Physician	$0	$2.3M
Avera St Lukes	SD	General Acute Care Hospital	$0	$1.5M
Richard Conklin	SD	Hematology & Oncology Physician	$994.4K	$0
Patrick Parker	GA	Urology Physician	$783.5K	$0
Avera St Luke's	SD	Physical Therapist	$0	$607.7K
Avera St Luke's	SD	Emergency Medicine Physician	$0	$595.8K
Avera St. Luke's	SD	Diagnostic Radiology Physician	$0	$559.6K
Susheel Gundewar	SD	Interventional Cardiology Physician	$448.9K	$0
Avera St. Luke's	SD	Psychiatry Physician	$0	$355.4K
Leslie Lenter	SD	Diagnostic Radiology Physician	$324K	$0

Nearby Providers

Other providers in the same ZIP code as Avera St. Luke's, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Adjustment Training Center, Inc.	SD	Developmentally Disabled Services Day Training Agency	$0	$40.3M
Northeastern Mental Health Center	SD	Mental Health Counselor	$0	$10.1M
Vision Care Associates, LLP	SD	Optometrist	$0	$6M
Sanford Health Network	SD	General Acute Care Hospital	$0	$4.4M
John Bormes	SD	Ophthalmology Physician	$2.6M	$0
Sanford Health Network	SD	General Acute Care Hospital	$0	$1.9M
Avera At Home	SD	Home Health Agency	$0	$1.6M
Ty Hanson	SD	Dermatology Physician	$1.2M	$0
Fettig And Drake Dds PC	SD	General Practice Dentistry	$0	$1M
Isurgery, LLC	SD	Ambulatory Surgical Clinic/Center	$998.3K	$0

Avera St. Luke's — Billing Profile & Reimbursement Data

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Avera St. Luke's — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References