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.

Rural Health Care, Inc. (NPI 1487667077)

Field	Value
Entity Type	Organization
Organization	Rural Health Care, Inc.
Address	202 Island Dr Ste 1
City	Fort Pierre
State	SD
ZIP	57532
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	August 14, 2006

Payer Source	Total Paid
Medicaid	$156.1K
Medicare	$0

Medicaid: Complete Services Breakdown

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

9 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…	950	$110	$105.3K
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,…	160	$130	$19.8K
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.	150	$120	$17.6K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	50	$130	$6.9K
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.	20	$130	$2.1K
99000	Use this code for the in office preparation of a specimen for lab analysis and or its transport from the office to the outside testing laboratory.	30	$60	$1.9K
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…	20	$120	$1.7K
W0037	N/A	240	$1	$710
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	20	$0	$0

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

Rural Health Care, Inc. — 0 of 8 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

9 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…	178	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…	254	260	860	$80	$222.6K
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.	53	60	120	$210	$171.2K
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,…	88	160	210	$120	$97.4K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	112	160	180	$40	$59.6K
W0037	N/A	127	160	690	$20	$50.1K
99000	Use this code for the in office preparation of a specimen for lab analysis and or its transport from the office to the outside testing laboratory.	13	20	220	$20	$24.2K
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.	47	80	210	$30	$18K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	113	130	110	$10	$6.9K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Rural Health Care, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sanford Medical Center	SD	Family Medicine Physician	$0	$68.8M
Rural Health Care, Inc	MN	Federally Qualified Health Center (FQHC)	$0	$15.9M
Rural Health Care, Inc	MN	Federally Qualified Health Center (FQHC)	$0	$10.1M
Rural Health Care, Inc	SD	Federally Qualified Health Center (FQHC)	$0	$4.4M
Rural Health Care, Inc	SD	Federally Qualified Health Center (FQHC)	$0	$2.1M
City Of Brookings	SD	Multi-Specialty Clinic/Center	$0	$1.2M
Rural Health Care, Inc.	SD	Federally Qualified Health Center (FQHC)	$0	$233.9K
Tarek Mahrous	SD	Interventional Cardiology Physician	$210.6K	$0
Douglas Holum	SD	Family Medicine Physician	$200.8K	$0
Michael Gerlach	SD	Family Medicine Physician	$187.8K	$0

Nearby Providers

Other providers in the same ZIP code as Rural Health Care, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hofer Family Dentistry	SD	General Practice Dentistry	$0	$165.3K
Brothers Pharmacies Inc	SD	Community/Retail Pharmacy	$59.7K	$0

Rural Health Care, Inc. — Billing Profile & Reimbursement Data

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Rural Health Care, Inc. — 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