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

Why is the Medicaid comparison limited to North 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. North 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.

St Josephs Hospital And Health Center (NPI 1508896861)

Key Findings

Field	Value
Entity Type	Organization
Organization	St Josephs Hospital And Health Center
Address	30 7th St W
City	Dickinson
State	ND
ZIP	58601
Taxonomy	Rural Acute Care Hospital
NPI Enumerated	July 3, 2006

Payer Source	Total Paid
Medicaid	$4.1M
Medicare	$0

This provider is effectively single‑payer in the available data: there is no Medicare billing on file while total Medicaid revenue is $4.1M, so Medicaid accounts for the entirety of reported lifetime revenue. That concentration means any payer-policy change at the state Medicaid level would disproportionately affect the hospital’s topline.

Revenue is highly concentrated in a very small set of codes: the top 3 Medicaid codes by revenue account for 87.7% of this provider's total Medicaid revenue. Those three codes are dominated by emergency department evaluation-and-management codes rather than a broad inpatient or procedural mix.

The operational profile is ED‑centric. 99284 (6.7K claims, $300 avg paid/claim, $2M revenue, 48.9% of Medicaid revenue), 99283 (7.4K claims, $174 avg paid/claim, $1.3M revenue, 31.6% of Medicaid revenue), and 99285 (716 claims, $414 avg paid/claim, $296.4K revenue, 7.2% of Medicaid revenue) together drive the bulk of billing, indicating the facility mainly generates Medicaid revenue through emergency department visits with a mix of low‑, moderate‑, and high‑complexity encounters.

Competitive standing within the state is modest and generally described as “typical.” 99284 ranks #12 of 33 in‑state (66th percentile; typical, unremarkable volume for this code), 99283 ranks #13 of 48 (74th percentile; typical, unremarkable volume for this code), and 99285 ranks #11 of 19 (44th percentile; typical, unremarkable volume for this code), which points to ordinary ED volumes relative to peers rather than dominance.

Ancillary services appear present but are minor revenue contributors compared with ED E/M codes: 80053 (CMP) generated $78.2K (1.9%), 85025 (CBC) $54.2K (1.3%), and imaging entries such as 70450 ($15.7K, 0.4%) and 74177 ($8.8K, 0.2%) together represent small shares of the $4.1M Medicaid total. These line items suggest basic lab, imaging, and infusion capabilities that support ED throughput but do not materially diversify revenue.

High claim counts for low‑priced routine services coexist with the ED revenue drivers, signaling a volume‑driven model: for example, 36415 shows 9.1K claims at $4 avg paid/claim for $36.4K (0.9% of Medicaid revenue) while 99283 records 7.4K claims. The pattern is consistent with frequent, lower‑paid encounters and point‑of‑care testing supporting ED workflows rather than revenue from high‑margin procedural activity.

The provider has an established market presence, with its NPI enumerated 2006-07-03 (~20 years ago), indicating longevity as a rural acute care hospital in Dickinson, ND. That tenure, combined with the Medicaid concentration, implies the hospital serves a longstanding local patient base heavily reliant on Medicaid coverage.

Concentration risk is material: with 87.7% of Medicaid revenue tied to three ED E/M codes and no Medicare billing reported, the hospital’s financial exposure is sensitive to shifts in ED utilization patterns or Medicaid reimbursement changes. The absence of Medicare revenue removes a diversification buffer that many peers have, making state Medicaid policy and local ED demand primary drivers of financial performance.

Medicaid: Complete Services Breakdown

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

66 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	6,660	$300	$2M
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.	7,420	$170	$1.3M
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.	720	$410	$296.4K
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.	4,890	$20	$78.2K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	870	$80	$67.9K
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	460	$140	$64K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	4,510	$10	$54.2K
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.	500	$80	$38.7K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	9,100	$1	$36.4K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	380	$90	$34.3K

Showing 1–10 of 66

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Dakota Distribution

St Josephs Hospital And Health Center — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Dakota

Full comparison — all codes billed, vs. North Dakota median

66 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.	11	20	1,120	$220	$2M
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.	12	30	1,280	$180	$1.4M
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.	13	50	670	$150	$829.9K
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…	109	210	360	$100	$498.2K
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.	24	30	450	$110	$198.3K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	9	10	1,400	$50	$172.8K
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.	15	20	230	$90	$153.4K
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.	7	10	630	$150	$148.3K
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.	19	20	920	$30	$111.2K
0241U	N/A	14	20	200	$130	$62.2K

Showing 1–10 of 66

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Coal Country Community Health Center	ND	Federally Qualified Health Center (FQHC)	$0	$983.2K
Darrin Johnson	MN	Diagnostic Radiology Physician	$908.4K	$0
Shree Subedi	WA	Diagnostic Radiology Physician	$774.2K	$0
Matthew Manganaro	NY	Diagnostic Radiology Physician	$688K	$0
Michael Lin	MN	Diagnostic Radiology Physician	$142.8K	$270.1K
St Joseph's Hospital And Health Center	ND	Clinic/Center	$0	$398.8K
Bradley Close	MN	Diagnostic Radiology Physician	$397.3K	$0
Coal Country Community Health Center	ND	Federally Qualified Health Center (FQHC)	$0	$384.7K
St Joseph's Hospital And Health Center	ND	Critical Access Hospital	$0	$336K
St Joseph's Hospital And Health Center	ND	Rural Health Clinic/Center	$0	$284.5K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Able Inc	ND	Community/Behavioral Health Agency	$0	$39.8M
Hit Inc.	ND	Early Intervention Provider Agency	$0	$17.4M
Dickinson Area Ambulance Service Inc	ND	Land Ambulance	$574.5K	$1.8M
Omaha Therapy, Inc	ND	Rehabilitation Clinic/Center	$0	$1.8M
Badlands Behavioral Health Clinic	ND	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$1.4M
High Plains Dental	ND	General Practice Dentistry	$0	$1.1M
Sanford Bismarck	ND	Multi-Specialty Clinic/Center	$0	$771.3K
Heartview Foundation Dickinson	ND	Substance Use Disorder Rehabilitation Clinic/Center	$0	$677.5K
Joann Nupen Lindemann	ND	Family Nurse Practitioner	$517.4K	$0
Wonderment Therapies PLLC	ND	Behavior Analyst	$0	$395K

St Josephs Hospital And Health Center — 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