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.

Sanford Clinic (NPI 1588322515)

Field	Value
Entity Type	Organization
Organization	Sanford Clinic
Address	901 4th St Nw
City	Watertown
State	SD
ZIP	57201
Taxonomy	Community Health Clinic/Center
NPI Enumerated	December 7, 2021

Payer Source	Total Paid
Medicaid	$223.1K
Medicare	$0

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
98960	A nonphysician qualified healthcare professional uses a standard curriculum to educate a patient about their disease or disorder and how to manage it more effectively. This code represents each 30…	4,790	$30	$158K
98961	A nonphysician qualified healthcare professional uses a standard curriculum to educate a patient about their disease or disorder and how to manage it more effectively. This code represents each 30…	2,380	$20	$42.9K
98962	A nonphysician qualified healthcare professional uses a standard curriculum to educate a patient about their disease or disorder and how to manage it more effectively. This code represents each 30…	1,580	$10	$22.2K

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

Sanford Clinic — 3 of 3 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

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
98960	A nonphysician qualified healthcare professional uses a standard curriculum to educate a patient about their disease or disorder and how to manage it more effectively. This code represents each 30…	1	10	220	$40	$27.9K
98961	A nonphysician qualified healthcare professional uses a standard curriculum to educate a patient about their disease or disorder and how to manage it more effectively. This code represents each 30…	1	10	1,250	$20	$22.5K
98962	A nonphysician qualified healthcare professional uses a standard curriculum to educate a patient about their disease or disorder and how to manage it more effectively. This code represents each 30…	1	10	810	$10	$11.3K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Human Service Agency	SD	Addiction (Substance Use Disorder) Counselor	$0	$39M
Brown Clinic Pllp	SD	Family Medicine Physician	$0	$3.1M
Thane Evans Crump Dds PC	SD	Endodontics	$0	$2.3M
Human Service Agency	SD	Case Management Agency	$0	$2.3M
Sanford Clinic	SD	Family Medicine Physician	$0	$2M
Prairie Lakes Health Care System Inc	SD	Rural Acute Care Hospital	$0	$2M
Prairie Lakes Home Connections	SD	Supports Brokerage Agency	$0	$1.2M
Big Stone Therapies Watertown, LLC	SD	Physical Therapy Clinic/Center	$0	$1.1M
City Of Watertown	SD	Land Ambulance	$475.4K	$390.4K
Bridgeway Counseling Center Inc.	SD	Psychologist	$0	$813.1K

Sanford Clinic — Billing Profile & Reimbursement Data

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Sanford Clinic — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References