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.

Grube Retina Clinic PC (NPI 1528389871)

Field	Value
Entity Type	Organization
Organization	Grube Retina Clinic PC
Address	107 3rd Ave Nw
City	Mandan
State	ND
ZIP	58554
Taxonomy	Ophthalmology Physician
NPI Enumerated	June 21, 2010

Payer Source	Total Paid
Medicaid	$65.7K
Medicare	$0

Medicaid: Complete Services Breakdown

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

4 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…	1,100	$40	$42K
92134	The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.	1,950	$10	$21.4K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	40	$40	$1.5K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	50	$20	$770

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

Grube Retina Clinic PC — 0 of 4 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

4 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…	61	210	360	$100	$498.2K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	10	10	350	$90	$61.2K
92134	The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.	5	10	1,110	$10	$21.9K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	3	10	90	$30	$11.6K

Nearby Providers

Other providers in the same ZIP code as Grube Retina Clinic PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Easter Seals Goodwill Nd, Inc.	ND	Community/Behavioral Health Agency	$0	$70.5M
Hit Inc.	ND	Community/Behavioral Health Agency	$0	$55.1M
Hit Inc.	ND	Community/Behavioral Health Agency	$0	$27.7M
Prairie Rose Family Dentists	ND	Dentist	$0	$1.6M
Kids In Motion Inc	ND	Physical Therapy Clinic/Center	$0	$1.5M
Easter Seals Goodwill Nd, Inc.	ND	In Home Supportive Care Agency	$0	$1M
Western Plains Public Health	ND	Public Health or Welfare Agency	$68.7K	$174.6K
Carter Chiropractic P C	ND	Chiropractor	$0	$187.2K
Mcbw Chiropractic PC	ND	Chiropractor	$0	$160.7K
Laura Archuleta	ND	Family Medicine Physician	$133.3K	$0

Grube Retina Clinic PC — Billing Profile & Reimbursement Data

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Grube Retina Clinic PC — Billing Profile & Reimbursement Data

Sign up for Grube Retina Clinic PC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References