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

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

Phs Indian Hospital (NPI 1508809765)

Key Findings

Field	Value
Entity Type	Organization
Organization	Phs Indian Hospital
Address	Hwy 1 Hospital Dr
City	Red Lake
State	MN
ZIP	56671
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 14, 2006

Payer Source	Total Paid
Medicaid	$59.4M
Medicare	$0

PHS INDIAN HOSPITAL is effectively single‑payer in the available data: Medicare shows none (no Medicare billing on file) while Medicaid revenue is $59.4M. This concentration means the provider’s financial footprint in federal programs is driven entirely by Medicaid activity in the available dataset, not by fee‑for‑service Medicare claims.

Revenue is highly concentrated in a small set of outpatient and emergency evaluation-and-management codes: the top 3 Medicaid codes (99283, 99213, 99282) account for 56.8% of the provider’s total Medicaid revenue. Individually, 99283 generated $13.3M (23.4%), 99213 generated $12.8M (22.5%), and 99282 generated $6.1M (10.8%), indicating these E/M services are the principal revenue drivers.

The code mix points to a hybrid hospital operation with heavy reliance on emergency department care and ambulatory primary/urgent care: 99283 has 28.1K claims, 99213 has 25.3K claims, and 99282 has 10.9K claims, each producing multi‑million dollar Medicaid revenue. In addition to ED visits, a sizable share of revenue comes from routine office E/M codes (99211, 99214, 99212) and procedural/diagnostic outpatient codes, consistent with a general acute care hospital that also delivers substantial outpatient services.

State-level competitive standing is mixed but strong in several areas: 99282 ranks #9 of 146 providers in-state (94th percentile) and 99211 ranks #7 of 162 (96th percentile), both indicating above-typical statewide volumes for those services. At the same time, 99213 ranks #85 of 1201 (93th percentile) and 99283 ranks #18 of 218 (92th percentile), which the underlying labels call "typical, unremarkable volume" despite high percentiles — together these positions suggest PHS is a meaningful regional provider for ED and outpatient E/M services but not necessarily a statewide dominant system across all service lines.

Beyond core E/M activity, the provider bills a variety of ambulatory specialties and ancillary services that diversify Medicaid revenue: ophthalmology codes 92014 ($1.3M) and 92004 ($862.6K), behavioral health psychotherapy 90837 ($1.1M), pediatric preventive visits 99392 ($468.6K) and 99393 ($347.2K), and pharmacist medication‑therapy management 99606 ($408.1K) all appear in the top Medicaid codes. This mix indicates on‑site specialty outpatient clinics, mental health services, pediatric preventive care, and pharmacy services are part of the operating footprint.

Several individual codes are labeled as "notably above typical state volume" or high percentile outliers, signaling particular service strengths: 99211 (96th percentile, notably above typical), 99441 (96th percentile, notably above typical), 0012A (96th percentile, notably above typical), 0011A (97th percentile, notably above typical) and 0064A (98th percentile, notably above typical). These flags suggest unusually high state-level activity in selected low‑level office visits, certain unspecified procedure administration codes, and related services that could reflect focused programs or high local demand in those specific areas.

The claim counts and average paid/claim for top codes show volume-driven revenue more than high unit prices: for example 99283 has 28.1K claims at $472 avg paid/claim and 99213 has 25.3K claims at $506 avg paid/claim, indicating that patient throughput for routine ED and office visits is a primary revenue mechanism rather than unusually high per‑claim rates. This operational profile is consistent with a community hospital serving a sizable Medicaid population through frequent, lower‑acuity encounters.

PHS INDIAN HOSPITAL has an established presence in the provider registry, with an NPI enumeration date of 2006-06-14 (~20 years ago), which supports the interpretation that these Medicaid relationships and service patterns reflect long‑running operational behavior rather than a brief or newly established billing pattern. The longevity combined with the Medicaid concentration underscores that payer risk and strategic planning for this entity should prioritize Medicaid policy and local demand drivers.

Medicaid: Complete Services Breakdown

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

68 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	28,140	$470	$13.3M
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…	25,260	$510	$12.8M
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.	10,890	$560	$6.1M
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.	17,110	$360	$6.1M
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…	6,500	$470	$3.1M
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.	5,530	$460	$2.5M
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,…	3,310	$440	$1.4M
99441	N/A	2,800	$490	$1.4M
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	2,720	$490	$1.3M
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	2,560	$450	$1.1M

Showing 1–10 of 68

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Minnesota Distribution

Phs Indian Hospital — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. Minnesota median

68 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	149	160	580	$170	$1.8M
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.	59	210	980	$140	$1.7M
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.	18	220	1,730	$120	$1.3M
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…	280	1,180	1,150	$80	$605.7K
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…	85	1,200	1,030	$70	$549.7K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	355	1,140	1,010	$100	$543K
90834	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…	520	620	560	$80	$361.9K
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.	9	150	500	$110	$293.1K
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…	36	270	550	$70	$254.7K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	147	240	730	$100	$243.2K

Showing 1–10 of 68

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Roseline Ihim	MN	Internal Medicine Physician	$69.3K	$241.4K
Daniel Louvar	ND	Nephrology Physician	$222.8K	$0
Gautam Phadke	NC	Nephrology Physician	$178K	$0
Teresa Levitski-heikkila	MN	Nephrology Physician	$136.1K	$0
Craig Walvatne	MN	Vascular Surgery Physician	$102.9K	$0
Benjamin Woods	AZ	Emergency Medicine Physician	$45.6K	$0
John Silkensen	MN	Nephrology Physician	$22.9K	$0
Paul Strait	WI	Emergency Medicine Physician	$7.2K	$0
James Hatch	MN	Internal Medicine Physician	$5.5K	$0
Angelia Frederick	SD	Family Nurse Practitioner	$4.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Red Lake Medication Assisted Recovery Services	MN	Community/Behavioral Health Agency	$0	$20.8M
Red Lake Chemical Health Treatment Center	MN	Substance Abuse Rehabilitation Facility	$0	$12.6M
Red Lake Department Of Family And Children Services	MN	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$12M
Comprehensive Health Services	MN	Health Service Clinic/Center	$0	$4.8M
Thomas Luft	MN	Internal Medicine Physician	$177.5K	$216.2K
James Gabriel	MN	Emergency Medicine Physician	$1.9K	$0

Phs Indian Hospital — Billing Profile & Reimbursement Data

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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