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 Wisconsin for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Wisconsin 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. Wisconsin (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.

Vernon Memorial Healthcare, Inc. (NPI 1497750921)

Vernon Memorial Healthcare, Inc. is a critical access hospital provider located in Viroqua, Wisconsin. This profile covers 0 Medicare and 161 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	Vernon Memorial Healthcare, Inc.
Address	507 S Main St
City	Viroqua
State	WI
ZIP	54665
Taxonomy	Critical Access Hospital
NPI Enumerated	June 21, 2005

Payer Source	Total Paid
Medicaid	$9M
Medicare	$0

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

161 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	3,330	$410	$1.3M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	5,000	$170	$825.2K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	3,670	$220	$788.4K
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…	5,690	$90	$535.1K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	2,700	$200	$531.5K
99281	The provider sees a patient for the lowest level emergency department visit.	2,800	$190	$527.2K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	2,210	$220	$495.7K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	6,470	$80	$485.6K
96360	The provider introduces a catheter intravenously for supplementation of fluid and electrolytes for 31 minutes to one hour to treat severe cases of dehydration.	1,680	$280	$475.7K
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.	5,070	$60	$278.7K

Showing 1–10 of 161

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.

Claims Volume vs. Wisconsin Distribution

Vernon Memorial Healthcare, Inc. — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

161 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	67	140	3,200	$160	$1.1M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	115	360	1,550	$70	$614.4K
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.	114	430	760	$60	$484.6K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	46	190	1,790	$90	$390.9K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	34	40	150	$530	$381.9K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	49	140	2,200	$90	$358.4K
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.	77	330	1,350	$60	$338K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	56	170	720	$70	$272.7K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	78	260	3,590	$20	$232.2K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	110	190	620	$40	$226.6K

Showing 1–10 of 161

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Health System Corporation	WI	Multi-Specialty Clinic/Center	$0	$13.2M
Steven Whitford	WI	Ophthalmology Physician	$377.7K	$0
Wah Wah Htun	WI	Interventional Cardiology Physician	$182.6K	$170.8K
Todd Ebbert	WI	Diagnostic Radiology Physician	$249.5K	$0
Keith Baynes	WI	Diagnostic Radiology Physician	$149.8K	$100
Matthew Ferroni	IA	Urology Physician	$139.7K	$0
Jeffrey Fogle	IA	Emergency Medicine Physician	$27.1K	$64.5K
Timothy Whitehead	IL	Vascular & Interventional Radiology Physician	$56.6K	$16.1K
Lukasz Babiarz	WI	Diagnostic Radiology Physician	$71.2K	$0
Ross Cerniglia	WI	Diagnostic Radiology Physician	$68.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Strive Ccs	WI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$5M
Vernon County Dept Of Human Services	WI	Community/Behavioral Health Agency	$0	$3.1M
Vernon Area Rehabilitation Center Inc	WI	Non-emergency Medical Transport (VAN)	$0	$1.6M
Jeffrey Lawrence	WI	Orthopaedic Surgery Physician	$198.4K	$0
Randy Mickelson	WI	Physician Assistant	$37.5K	$0
Colin Kratochwill	WI	Surgical Physician Assistant	$32.9K	$0

Vernon Memorial Healthcare, 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

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