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

Why is the Medicaid comparison limited to South 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. South 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.

Monument Health Network, Inc. (NPI 1558740472)

Field	Value
Entity Type	Organization
Organization	Monument Health Network, Inc.
Address	71 Charles St
City	Deadwood
State	SD
ZIP	57732
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	May 26, 2015

Payer Source	Total Paid
Medicaid	$357.7K
Medicare	$0

Medicaid: Complete Services Breakdown

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

17 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…	1,800	$80	$135.2K
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…	2,660	$50	$119.5K
W0037	N/A	1,930	$30	$59.8K
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…	110	$130	$14.4K
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…	70	$130	$8.7K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	1,670	$10	$8.3K
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.	290	$20	$4.9K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	250	$10	$3K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	170	$10	$1.2K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	30	$20	$650

Showing 1–10 of 17

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Dakota Distribution

Monument Health Network, Inc. — 0 of 15 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

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

17 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…	104	340	1,010	$100	$511K
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…	84	260	860	$80	$222.6K
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.	23	60	120	$210	$171.2K
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…	156	190	430	$90	$154.1K
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…	38	70	130	$100	$99K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	44	110	990	$20	$82.9K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	75	160	180	$40	$59.6K
W0037	N/A	52	160	690	$20	$50.1K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	61	70	450	$20	$29.2K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	68	80	210	$30	$18K

Showing 1–10 of 17

Related Providers

Other providers that share a Tax Identification Number (TIN) with Monument Health Network, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$2M
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$1.8M
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$745.7K
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$737.5K
Monument Health Network, Inc.	SD	Family Medicine Physician	$0	$639K
Monument Health Network, Inc.	SD	General Acute Care Hospital	$0	$440.6K
Rakesh Ponnapureddy	IA	Cardiovascular Disease Physician	$250.8K	$0
Ethan Levine	NY	Clinical Cardiac Electrophysiology Physician	$222.4K	$220
Monument Health Network, Inc.	SD	General Acute Care Hospital	$0	$214.2K
Joseph Tuma	SD	Interventional Cardiology Physician	$209.4K	$0

Nearby Providers

Other providers in the same ZIP code as Monument Health Network, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Black Hills Special Services	SD	Case Management Agency	$0	$500.2K
Deadwood Eye Care LLC	SD	Optometrist	$0	$190.9K
Lennard Hopper, D.d.s., P.C.	SD	General Practice Dentistry	$0	$173.6K
Elizabeth Sayler	SD	Internal Medicine Physician	$6.1K	$0
Jocelyn Bergh	SD	Physician Assistant	$4.5K	$0

Monument Health Network, Inc. — Billing Profile & Reimbursement Data

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Monument Health Network, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References