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.

City Of Sioux Falls (NPI 1508103243)

Field	Value
Entity Type	Organization
Organization	City Of Sioux Falls
Address	410 N Valley View Rd
City	Sioux Falls
State	SD
ZIP	57107
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	January 15, 2013

Payer Source	Total Paid
Medicaid	$210.4K
Medicare	$0

Medicaid: Complete Services Breakdown

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…	1,130	$120	$131.1K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	190	$140	$25.7K
D0120	Periodic oral evaluation - established patient	130	$190	$24.3K
D0150	Comprehensive oral evaluation – new or established patient	50	$190	$8.5K
D1120	Prophylaxis–child	40	$180	$6.5K
D2391	Resin‑based composite – one surface, posterior	60	$80	$5.1K
D2392	Post 2 surface resin‑based composite	40	$110	$4.8K
D1351	Sealant - per tooth	210	$20	$3.6K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	30	$30	$750
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	90	$1	$180

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

City Of Sioux Falls — 0 of 10 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…	161	340	1,010	$100	$511K
D1351	Sealant - per tooth	32	50	400	$30	$117.3K
D2391	Resin‑based composite – one surface, posterior	28	40	150	$80	$115.5K
D2392	Post 2 surface resin‑based composite	43	60	100	$100	$89.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	90	110	990	$20	$82.9K
D1120	Prophylaxis–child	117	140	150	$40	$59.7K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	79	160	180	$40	$59.6K
D0210	Intraoral - complete series of radiographic images	32	40	40	$100	$55.6K
D0120	Periodic oral evaluation - established patient	127	180	320	$30	$50.8K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	117	160	270	$30	$50.1K

Showing 1–10 of 14

Related Providers

Other providers that share a Tax Identification Number (TIN) with City Of Sioux Falls, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
City Of Sioux Falls	SD	Federally Qualified Health Center (FQHC)	$0	$8.6M
City Of Sioux Falls	SD	Federally Qualified Health Center (FQHC)	$0	$126K
City Of Sioux Falls	SD	Federally Qualified Health Center (FQHC)	$0	$121K
Suzanne Tarver	OK	Physician Assistant	$38.7K	$0
James Wilde	SD	Family Medicine Physician	$11.1K	$0
Jennifer Tinguely	SD	Family Medicine Physician	$2.1K	$0

Nearby Providers

Other providers in the same ZIP code as City Of Sioux Falls, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Avera Mckennan	SD	Home Infusion Agency	$0	$6.7M
Eli Home Care LLC	SD	Home Health Agency	$0	$1.5M
Avera Mckennan	SD	Long Term Care Pharmacy	$880.7K	$53.7K
Walmart Inc.	SD	Community/Retail Pharmacy	$58.1K	$0
Keri Orstad	SD	Family Medicine Physician	$50.6K	$0

City Of Sioux Falls — Billing Profile & Reimbursement Data

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City Of Sioux Falls — 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