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

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

Pawnee Valley Community Hospital Inc (NPI 1518394147)

Pawnee Valley Community Hospital Inc is a rural health clinic/center provider located in Larned, Kansas. This profile covers 0 Medicare and 11 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	Pawnee Valley Community Hospital Inc
Address	713 W 11th St
City	Larned
State	KS
ZIP	67550
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	September 27, 2013

Payer Source	Total Paid
Medicaid	$807.6K
Medicare	$0

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

11 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…	4,670	$110	$522.5K
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…	2,290	$90	$212.9K
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,…	550	$100	$53.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	70	$130	$9.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	40	$180	$7K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	20	$50	$770
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	10	$60	$760
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	50	$10	$620
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	30	$0	$0
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	20	$0	$0

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kansas Distribution

Pawnee Valley Community Hospital Inc — 0 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kansas

Full comparison — all codes billed, vs. Kansas median

11 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…	179	1,050	560	$80	$266.8K
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…	198	880	400	$60	$136K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	141	190	180	$110	$94.2K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	86	100	390	$30	$78.1K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	100	120	550	$30	$73K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	123	200	130	$130	$58.6K
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,…	71	340	100	$100	$43.3K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	86	90	300	$10	$22.2K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	114	120	70	$60	$18K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	114	170	110	$10	$9.4K

Showing 1–10 of 11

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hays Medical Center Inc	KS	General Acute Care Hospital	$0	$595.8K
Aaron Pfeifer	KS	Emergency Medicine Physician	$82.8K	$0
Derek Yarmer	KS	Emergency Medicine Physician	$77.8K	$0
Gregory Seiler	KS	Certified Registered Nurse Anesthetist	$48.8K	$0
Calvin Kruger	KS	Physician Assistant	$28.4K	$0
Krista Dechant	KS	Certified Registered Nurse Anesthetist	$18.4K	$0
Taylor David	KS	Certified Registered Nurse Anesthetist	$7.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Smith Dental Clinic LLC	KS	Dentist	$0	$995.6K
Trent Smith	KS	Dentist	$0	$808.6K
Heart Of Kansas Family Health Care, Inc.	KS	Federally Qualified Health Center (FQHC)	$0	$778.6K
County Of Pawnee	KS	Ambulance	$211.2K	$14.8K
Douglas Ayre	KS	Optometrist	$172.1K	$7.8K

Pawnee Valley Community Hospital Inc — Billing Profile & Reimbursement Data

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Pawnee Valley Community Hospital 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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