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.

St. Mary's Hospital Of Superior (NPI 1588691588)

St. Mary's Hospital Of Superior is a critical access hospital clinic/center provider located in Superior, Wisconsin. This profile covers 0 Medicare and 49 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	St. Mary's Hospital Of Superior
Address	3500 Tower Ave
City	Superior
State	WI
ZIP	54880
Taxonomy	Critical Access Hospital Clinic/Center
NPI Enumerated	June 26, 2006

Payer Source	Total Paid
Medicaid	$1.6M
Medicare	$0

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

49 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…	21,020	$50	$966.9K
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…	13,700	$30	$438.2K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	1,980	$40	$73.3K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	1,330	$20	$30.7K
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…	1,820	$20	$27.3K
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…	280	$60	$16.7K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	1,270	$10	$13.9K
99605	The pharmacist provides a 15–minute, in–person, patient–specific medication evaluation for a new patient based on factors such as the patient’s history and medication list.	210	$50	$10.7K
99310	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends…	450	$20	$9.5K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	240	$30	$8.1K

Showing 1–10 of 49

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

St. Mary's Hospital Of Superior — 1 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

49 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	188	360	1,550	$70	$614.4K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	254	430	760	$60	$484.6K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	163	190	1,790	$90	$390.9K
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…	145	170	720	$70	$272.7K
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…	61	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…	97	1,760	250	$40	$173.2K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	203	790	400	$40	$109.6K
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…	154	350	210	$60	$95.8K
0241U	N/A	95	100	990	$40	$92.2K
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,…	300	690	160	$60	$90.4K

Showing 1–10 of 49

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Duluth Clinic, Ltd	MN	Multi-Specialty Clinic/Center	$0	$51.7M
Smdc Medical Center	MN	General Acute Care Hospital	$0	$35.3M
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
St. Mary's Hospital Of Superior	WI	Critical Access Hospital	$0	$13.4M
Deer River Healthcare Center, Inc.	MN	Critical Access Hospital	$0	$4.6M
John Thompson	MD	Ophthalmology Physician	$3.9M	$0
Gregory Pippin	ND	Otolaryngology Physician	$48.4K	$1.7M
Yuyang Zhang	MD	Diagnostic Radiology Physician	$920.4K	$0
Darrin Johnson	MN	Diagnostic Radiology Physician	$908.4K	$0
Shree Subedi	WA	Diagnostic Radiology Physician	$774.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lake Superior Community Health Center	WI	Federally Qualified Health Center (FQHC)	$0	$4.9M
Lake Superior Community Health Center	WI	Federally Qualified Health Center (FQHC)	$0	$4.2M
Elisha Zavodnik	WI	Behavior Analyst	$0	$4.1M
Brightwater Health Dba Human Development Center	WI	Community/Behavioral Health Agency	$0	$3.4M
Douglas County	WI	Public Health or Welfare Agency	$0	$2.6M
The Creative Counseling Group	WI	Mental Health Counselor	$0	$1.2M
Walgreen Co	WI	Pharmacy	$245.3K	$54.3K
John Yoon	WI	Ophthalmology Physician	$153.8K	$0
Anna Greiner	WI	Physician Assistant	$29.2K	$0
Professional Portable Radiologic Services, Inc.	WI	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	$17.8K	$3K

St. Mary's Hospital Of Superior — Billing Profile & Reimbursement Data

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St. Mary's Hospital Of Superior — 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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