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.

T & L Quick Care PC (NPI 1437650751)

T & L Quick Care PC is a acute care nurse practitioner provider located in Watertown, South Dakota. This profile covers 0 Medicare and 14 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	T & L Quick Care PC
Address	1056 29th St Se
City	Watertown
State	SD
ZIP	57201
Taxonomy	Acute Care Nurse Practitioner
NPI Enumerated	February 22, 2018

Payer Source	Total Paid
Medicaid	$224.5K
Medicare	$0

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

14 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…	2,240	$30	$74K
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…	1,030	$50	$47.3K
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…	660	$60	$41.1K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	850	$20	$18.8K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	510	$30	$13.4K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	730	$10	$8.7K
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…	80	$100	$7.8K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	140	$40	$5.2K
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,…	130	$20	$2.5K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	80	$30	$2.4K

Showing 1–10 of 14

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

T & L Quick Care PC — 0 of 14 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

14 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…	113	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…	143	260	860	$80	$222.6K
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,…	94	160	210	$120	$97.4K
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…	24	100	160	$60	$64.4K
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…	46	80	120	$80	$61.5K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	20	50	420	$30	$54.1K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	27	30	170	$90	$43.6K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	65	80	210	$30	$18K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	13	70	210	$20	$14.7K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	7	40	50	$30	$14.1K

Showing 1–10 of 14

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Stefanie Robinson	SD	Acute Care Nurse Practitioner	$19.5K	$0
Holly Gisi-york	MN	Nurse Practitioner	$15.9K	$0
Heidi Barber	SD	Nurse Practitioner	$12K	$0
Maureen Higgins	PA	Family Nurse Practitioner	$9.9K	$0
Ashleigh Eilts	SD	Family Nurse Practitioner	$8K	$0
Melissa Magstadt	SD	Family Nurse Practitioner	$5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Human Service Agency	SD	Addiction (Substance Use Disorder) Counselor	$0	$39M
Brown Clinic Pllp	SD	Family Medicine Physician	$0	$3.1M
Thane Evans Crump Dds PC	SD	Endodontics	$0	$2.3M
Human Service Agency	SD	Case Management Agency	$0	$2.3M
Sanford Clinic	SD	Family Medicine Physician	$0	$2M
Prairie Lakes Health Care System Inc	SD	Rural Acute Care Hospital	$0	$2M
Prairie Lakes Home Connections	SD	Supports Brokerage Agency	$0	$1.2M
Big Stone Therapies Watertown, LLC	SD	Physical Therapy Clinic/Center	$0	$1.1M
City Of Watertown	SD	Land Ambulance	$475.4K	$390.4K
Bridgeway Counseling Center Inc.	SD	Psychologist	$0	$813.1K

T & L Quick Care PC — Billing Profile & Reimbursement Data

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T & L Quick Care PC — 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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