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.

Cheyenne River Sioux Tribe Field Health Clinic (NPI 1457593725)

Field	Value
Entity Type	Organization
Organization	Cheyenne River Sioux Tribe Field Health Clinic
Address	24276 166th St
City	Eagle Butte
State	SD
ZIP	57625
Taxonomy	Primary Care Clinic/Center
NPI Enumerated	April 1, 2009

Payer Source	Total Paid
Medicaid	$8M
Medicare	$0

Key Findings

This provider is effectively single-payer in the dataset: there is no Medicare billing on file and all reported lifetime revenue is Medicaid ($8M). Analysts should treat the billing profile as Medicaid-centric rather than split across Medicare and Medicaid.

Revenue is highly concentrated: the precomputed top-3 Medicaid codes account for 100.0% of the provider’s Medicaid revenue. The available code-level listing shows 99213 alone reported as generating $8M (100.0% of this provider's total Medicaid revenue), indicating almost all billed dollars flow from a very narrow set of visit codes.

The dominant code 99213 is an established-patient office or outpatient evaluation-and-management visit (low medical decision making or ~20 minutes total time). Combined with the provider taxonomy of Primary Care Clinic/Center, this code mix signals an operation focused on routine primary care, chronic-disease follow-up, and ambulatory visit-based care rather than procedure-driven specialty services.

Claim-level and payment metrics underscore that emphasis: 99213 appears 15.2K times with a $525 avg paid/claim and $8M in revenue. Because that single code drives the reported claims volume and dollars, visit-level outpatient encounters are the clear revenue driver for this clinic.

In statewide context the provider ranks #27 of 344 providers in-state for 99213 (92th percentile; typical, unremarkable volume for this code). That ranking places the clinic ahead of most peers on this common primary-care metric, yet the dataset explicitly classifies the volume as typical rather than an extreme outlier, so the provider is a notable but not anomalous participant for established-patient visits.

The NPI was enumerated on 2009-04-01 (~17 years ago), indicating a long-established billing presence; this tenure supports continuity of service and experience navigating Medicaid billing over multiple reimbursement cycles.

The extreme concentration of Medicaid revenue in a single E/M code creates material exposure to policy or payment changes affecting office visits. Analysts should flag revenue volatility risk from any adjustments to E/M valuation or documentation standards and consider whether the provider has non-billed revenue sources or opportunities to diversify services to reduce that dependence.

Medicaid: Complete Services Breakdown

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

1 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…	15,180	$530	$8M

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

Cheyenne River Sioux Tribe Field Health Clinic — 0 of 1 code 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

1 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…	27	340	1,010	$100	$511K

Nearby Providers

Other providers in the same ZIP code as Cheyenne River Sioux Tribe Field Health Clinic, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eagle Butte Indian Health Service Hospital	SD	Public Health or Welfare Agency	$0	$19.2M
Blackhills Dialysis, L.L.C.	SD	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$5.6M
Horizon Health Care Inc	SD	Federally Qualified Health Center (FQHC)	$0	$2.3M
Missouri Breaks Industries Research, Inc.	SD	Durable Medical Equipment & Medical Supplies	$0	$2M
Cheyenne River Dental Clinic	SD	Public Health Dentistry	$0	$1.6M
Margaret Upell	SD	Family Medicine Physician	$21.2K	$377.7K
Medicine Wheel Village	SD	Assisted Living Facility	$0	$119.7K
Jaime Aguilar	SD	Physician Assistant	$8K	$0

Cheyenne River Sioux Tribe Field Health Clinic — Billing Profile & Reimbursement Data

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Cheyenne River Sioux Tribe Field Health Clinic — Billing Profile & Reimbursement Data

Sign up for Cheyenne River Sioux Tribe Field Health Clinic — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References