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

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

Oconto Hospital & Medical Center Inc (NPI 1528412673)

Oconto Hospital & Medical Center Inc is a rural health clinic/center provider located in Marinette, Wisconsin. This profile covers 0 Medicare and 92 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	Oconto Hospital & Medical Center Inc
Address	2820 Roosevelt Road
City	Marinette
State	WI
ZIP	54143
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	April 14, 2016

Payer Source	Total Paid
Medicaid	$4.2M
Medicare	$0

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

92 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	24,610	$50	$1.3M
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…	27,780	$30	$944.5K
T1015	Clinic visit/encounter, all-inclusive	35,170	$30	$879.2K
99204	The provider sees a new 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 provider…	1,360	$90	$115.8K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,970	$50	$100.5K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,980	$50	$89.3K
99203	The provider sees a new 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 provider…	1,460	$50	$75.7K
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…	770	$90	$70.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,290	$50	$68.3K
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.	4,100	$10	$36.9K

Showing 1–10 of 92

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wisconsin Distribution

Oconto Hospital & Medical Center Inc — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

92 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	12	60	4,880	$230	$4.9M
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…	160	170	720	$70	$272.7K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	56	80	650	$110	$244.4K
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.	126	260	3,590	$20	$232.2K
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…	53	1,630	270	$40	$205.3K
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…	50	1,760	250	$40	$173.2K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	395	500	3,140	$20	$148.9K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	451	630	2,500	$20	$135.5K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	143	260	690	$40	$133.8K
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	172	220	2,770	$20	$120.2K

Showing 1–10 of 92

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bellin Memorial Hospital Inc	WI	Family Medicine Physician	$0	$19.8M
Oconto Hospital & Medical Center Inc	WI	Critical Access Hospital	$0	$4.8M
Debbie Lim	WI	Rheumatology Physician	$1.8M	$0
Kevan Lewis	WI	MOHS-Micrographic Surgery Physician	$1.2M	$0
Paul Tuttle	WI	Rheumatology Physician	$861.3K	$0
Riley Smyth	WI	Diagnostic Radiology Physician	$805.1K	$320
Michael Avery	WI	Rheumatology Physician	$681.6K	$0
James Lee	CA	Cardiovascular Disease Physician	$373.1K	$0
Aaron Gould	IL	Diagnostic Radiology Physician	$126.2K	$209.3K
Trudi Parker	MN	Diagnostic Radiology Physician	$317.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aurora Medical Center Bay Area, Inc	WI	General Acute Care Hospital	$0	$9.7M
County Of Marinette	WI	Community/Behavioral Health Agency	$0	$4M
County Of Marinette	WI	Community Health Clinic/Center	$0	$2M
County Of Marinette	WI	Case Management Agency	$0	$1.8M
Aurora Medical Center Bay Area, Inc	WI	Land Ambulance	$0	$1.6M
Oconto Hospital & Medical Center, Inc.	WI	Ambulatory Surgical Clinic/Center	$235.5K	$5.5K
Nicholas Grimm	WI	Physician Assistant	$164.3K	$0
Yasser Salem	WI	Cardiovascular Disease Physician	$138K	$3K
Andrew Barker	WI	Physical Therapist	$103.5K	$0
Katie Livingston	WI	Radiation Oncology Physician	$85.9K	$0

Oconto Hospital & Medical Center 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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