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 1578942496)

Field	Value
Entity Type	Organization
Organization	Monument Health Network, Inc.
Address	1420 N 10th St
City	Spearfish
State	SD
ZIP	57783
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	May 26, 2015

Payer Source	Total Paid
Medicaid	$1.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

58 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…	18,160	$30	$617.3K
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…	9,580	$50	$440.5K
W0037	N/A	3,870	$40	$143.2K
0241U	N/A	790	$110	$83.2K
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…	1,060	$60	$61.3K
U0002	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	1,330	$50	$59.7K
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,…	2,470	$20	$56.8K
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…	1,730	$30	$44.9K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	1,030	$30	$29.9K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	5,620	$10	$28.1K

Showing 1–10 of 58

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. — 2 of 25 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

58 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…	20	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…	18	260	860	$80	$222.6K
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…	32	40	1,100	$80	$181.3K
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.	12	60	120	$210	$171.2K
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…	22	30	270	$70	$138.6K
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…	47	50	410	$80	$127.2K
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…	28	70	130	$100	$99K
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,…	17	160	210	$120	$97.4K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	20	110	990	$20	$82.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	44	60	170	$90	$66.3K

Showing 1–10 of 58

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 Rapid City Hospital, Inc	SD	Multi-Specialty Clinic/Center	$0	$18.7M
Monument Health Rapid City Hospital, Inc.	SD	General Acute Care Hospital	$0	$11.5M
Monument Health Rapid City Hospital, Inc.	SD	Multi-Specialty Clinic/Center	$0	$5.2M
Richard White	AR	Hematology & Oncology Physician	$2.2M	$0
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$2M
Jennifer May	SD	Internal Medicine Physician	$1.9M	$0
Monument Health Rapid City Hospital, Inc.	SD	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.6M
Luke Hushagen	SD	Internal Medicine Physician	$1.4M	$0
Don Wynn	TX	Pulmonary Disease Physician	$1.4M	$0
Monument Health Rapid City Hospital, Inc.	SD	Urgent Care Clinic/Center	$0	$1.3M

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
Northern Hills Training Center, Inc.	SD	Developmentally Disabled Services Day Training Agency	$0	$39.3M
Lutheran Social Services Of Sd	SD	Psychiatric Residential Treatment Facility	$0	$16.9M
A.w. Holdings, LLC	SD	Case Manager/Care Coordinator	$0	$3.7M
Edgewood Spearfish Senior Living LLC	SD	Assisted Living Facility (Behavioral Disturbances)	$0	$2.3M
Spearfish Emergency Ambulance Service	SD	Land Ambulance	$540.7K	$302.3K
West River Transit Authority, Inc.	SD	Bus	$0	$788.1K
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$745.7K
Spearfish Collaborative Care LLC	SD	Assisted Living Facility	$0	$657.7K
Black Hills Psychology, LLC	SD	Clinical Psychologist	$0	$601.6K
Monument Health Network, Inc.	SD	General Acute Care Hospital	$0	$440.6K

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