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.

Yankton Medical Clinic PC (NPI 1447251350)

Key Findings

Field	Value
Entity Type	Organization
Organization	Yankton Medical Clinic PC
Address	1104 W 8th St
City	Yankton
State	SD
ZIP	57078
Taxonomy	Internal Medicine Physician
NPI Enumerated	August 2, 2005

Payer Source	Total Paid
Medicaid	$6.3M
Medicare	$0

YANKTON MEDICAL CLINIC PC is effectively a Medicaid-focused practice: it has no Medicare billing on file and reports $6.3M in lifetime Medicaid revenue, indicating operational emphasis on Medicaid populations rather than Medicare beneficiaries. This payer concentration means analyses of care mix and financial performance should center on Medicaid encounter and preventive care patterns.

Revenue concentration is high: the precomputed top three Medicaid codes account for 56.7% of the provider’s total Medicaid revenue, signaling dependency on a small set of outpatient evaluation-and-management and preventive services to generate the majority of income. That level of concentration suggests the clinic’s financial health is sensitive to reimbursement or utilization shifts for those leading codes.

Primary service mix is ambulatory primary care and preventive services: high volumes and revenue from 99213, 99214, and related E/M codes (also including 99203/99204 and pediatric well visits 99391/99392) indicate the practice operates as a general internal/family medicine clinic managing established and new outpatient visits and routine preventive care. The presence of vaccination codes (90471/90472) and pediatric/early-life care codes (99460) further supports a broad outpatient primary care and immunization service line.

Competitive standing in-state is strong for core office visit codes: 99213 and 99214 each rank #4 in-state and are in the 99th percentile, which positions the clinic as a high-volume provider of established patient E/M services compared with peers. Additional high-percentile rankings (many codes in the 90s percentile) reinforce that the practice is a major regional player for common ambulatory care services.

Several diagnostic testing codes also contribute meaningfully, reflecting on-site lab or rapid testing throughput: 87633, 87635, 87651, U0003, 87502, and 87804 together appear across the top-25 list and include respiratory virus and SARS-CoV-2 testing. Notably, 87633 ranks #3 of 8 and 87635 ranks #3 of 37 in-state, indicating meaningful diagnostic testing volume that complements the clinic’s outpatient visits and likely supports episodic acute care and infection surveillance.

The clinic shows outsized volume for lower- and mid-level E/M codes as statistical outliers: 99212 and 99213 are in the 99th percentile (99212 labeled an "extreme outlier, far above typical state volume" for that code), which suggests high throughput of brief established-patient visits and routine follow-ups. This pattern points to a workflow optimized for high patient visit counts and frequent, lower-intensity encounters.

Tenure is long-standing: the NPI was enumerated on 2005-08-02 (~21 years ago), indicating sustained presence in the market and allowing time to build the high utilization and state-level rankings seen in multiple codes. That longevity supports continuity of patient panels and likely contributes to the practice’s high volume on core Medicaid codes.

Service mix includes significant maternal/child and procedural components: codes such as 76816 (fetal reexamination), multiple well-child codes (99391/99392/99393/99394), and newborn care 99460 indicate that the clinic provides obstetric follow-up and pediatric preventive services alongside adult internal medicine. The combination of prenatal/fetal imaging follow-up and newborn/child well visits suggests a multi-generational primary care offering that captures a broad Medicaid population.

Though many codes rank high in-state, some advanced or specialized services remain moderate: examples include echocardiography 93306 and inpatient discharge management 99238, which rank in more middle percentiles (76th–80th). This pattern implies the clinic is primarily focused on ambulatory primary care and diagnostics rather than being a dominant provider of higher-acuity inpatient or specialty procedural services within the state.

Medicaid: Complete Services Breakdown

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

227 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…	55,170	$30	$1.8M
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…	24,430	$40	$977.1K
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…	4,230	$60	$270.7K
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…	3,320	$60	$209.2K
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	570	$330	$188.2K
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…	4,000	$50	$179.9K
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.	5,330	$30	$170.4K
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…	2,360	$60	$148.8K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	6,310	$20	$138.8K
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…	2,780	$50	$133.2K

Showing 1–10 of 227

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

Yankton Medical Clinic PC — 7 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

227 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90999	Use 90999 to report dialysis services or procedures that do not have a specific code.	18	30	3,520	$50	$769.4K
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	5	10	30	$1,280	$579.7K
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…	4	340	1,010	$100	$511K
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	34	40	270	$180	$281.6K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	29	40	340	$90	$234.9K
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…	4	260	860	$80	$222.6K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	35	60	680	$60	$205.7K
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	31	30	300	$150	$195.3K
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…	5	40	1,100	$80	$181.3K
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…	47	70	200	$80	$176.7K

Showing 1–10 of 227

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mary Lee Villanueva	SD	Hematology & Oncology Physician	$788.7K	$0
Timothy Irwin	SD	Cardiovascular Disease Physician	$383.8K	$0
Byron Nielsen	SD	Nephrology Physician	$378.6K	$0
Susan Fanta	SD	Internal Medicine Physician	$323.6K	$0
Leann Bassing	SD	Rheumatology Physician	$305.1K	$0
Jeremy Kudera	SD	Orthopaedic Surgery Physician	$287.3K	$0
Tyler Hanson	SD	Internal Medicine Physician	$271.5K	$0
Yankton Medical Clinic PC	SD	Ambulatory Surgical Clinic/Center	$255.8K	$0
Alyssa Mrsny	SD	Physician Assistant	$237.3K	$0
Melissa Fullner-marshall	SD	Medical Physician Assistant	$230.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ability Building Services, Inc.	SD	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$39.2M
Lewis & Clark Behavioral Health Services, Inc.	SD	Community/Behavioral Health Agency	$0	$24M
Yankton Ph	SD	Assisted Living Facility (Mental Illness)	$0	$4.1M
Cedar Vilage Assisted Living Center	SD	Assisted Living Facility (Mental Illness)	$0	$2.4M
Heartland Psychological Services	SD	Psychiatry Physician	$0	$1.3M
Avera At Home	SD	Home Health Agency	$0	$1M
Sacred Heart Health Services	SD	Rural Acute Care Hospital	$0	$942.8K
Sacred Heart Health Services	SD	Emergency Care Clinic/Center	$0	$766.6K
Kore Cares In Home Services, LLC	SD	In Home Supportive Care Agency	$0	$700.6K
Autumn Winds LLC	SD	Assisted Living Facility	$0	$628K

Yankton Medical Clinic PC — Billing Profile & Reimbursement Data

Sign up for Yankton Medical Clinic PC — Billing Profile & Reimbursement Data policy alerts

Yankton Medical Clinic PC — Billing Profile & Reimbursement Data

Sign up for Yankton Medical Clinic PC — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References