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 1598144719)

Field	Value
Entity Type	Organization
Organization	Monument Health Network, Inc.
Address	2200 13th Ave
City	Belle Fourche
State	SD
ZIP	57717
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	May 20, 2015

Payer Source	Total Paid
Medicaid	$876.4K
Medicare	$0

Medicaid: Complete Services Breakdown

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

21 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…	5,450	$80	$458K
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,…	1,100	$80	$90K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	2,160	$40	$86.2K
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…	910	$80	$76.4K
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.	490	$100	$50K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	620	$50	$28.6K
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.	490	$50	$22K
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.	200	$100	$19.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	350	$40	$15.1K
W0037	N/A	2,270	$1	$9.1K

Showing 1–10 of 21

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 17 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

21 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…	67	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…	126	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.	17	60	120	$210	$171.2K
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,…	34	160	210	$120	$97.4K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	37	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.	51	60	170	$90	$66.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	63	160	180	$40	$59.6K
W0037	N/A	45	160	690	$20	$50.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	51	70	110	$110	$42.9K
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.	42	70	920	$20	$33.8K

Showing 1–10 of 21

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
Heartland Home Health LLC	SD	Home Health Agency	$0	$654.3K
Belle Fourche Counseling - LLC	SD	Community/Behavioral Health Agency	$0	$481.1K
Black Hills Optical LLP	SD	Durable Medical Equipment & Medical Supplies	$0	$245.5K
Belle Fourche School District 9-1	SD	Local Education Agency (LEA)	$0	$199K
Pain & Movement Solutions, LLC	SD	Physical Therapist	$0	$188.7K
Judy's Assisted Living	SD	Assisted Living Facility	$0	$170.3K
Butte County Ambulance Service	SD	Land Ambulance	$139.8K	$23.7K
Black Hills Vision Care Prof LLC	SD	Optometrist	$0	$133.1K
Jennifer Karp	SD	Family Nurse Practitioner	$99.8K	$0
Tri-state Chiropractic, PC	SD	Chiropractor	$0	$91.6K

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

Nearby Providers

Frequently Asked Questions

References