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.

John Simonson (NPI 1598184921)

Field	Value
Entity Type	Individual
Organization	John Simonson
Address	1305 W 18th St
City	Sioux Falls
State	SD
ZIP	57105
Taxonomy	Hospitalist Physician
NPI Enumerated	April 14, 2014

Payer Source	Total Paid
Medicare	$64.9K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	620	$60	$36.3K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	70	$130	$8.3K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	90	$90	$7.7K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	70	$90	$6.1K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	60	$60	$4K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	30	$90	$2.5K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Dakota Distribution

John Simonson — 1 of 6 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. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99233	218	290	60	$90	$10.8K
99232	11	570	80	$60	$9.2K
99223	109	340	40	$130	$7.5K
99239	76	220	50	$90	$5.4K
99222	40	450	30	$90	$3.5K
99238	17	180	20	$60	$1.9K

Related Providers

Other providers that share a Tax Identification Number (TIN) with John Simonson, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sanford Medical Center	SD	Family Medicine Physician	$0	$68.8M
Sanford Health Network	MN	Rural Acute Care Hospital	$0	$7.6M
Sanford Health Network	IA	Family Medicine Physician	$0	$6.6M
Sanford Clinic	SD	Diagnostic Radiology Physician	$0	$6M
Sanford Clinic	SD	Pediatrics Physician	$0	$5.5M
Sanford Health Network	SD	General Acute Care Hospital	$0	$4.4M
Sanford Clinic	SD	Hospitalist Physician	$0	$2.9M
Willamette Orthopedic Group LLC	OR	Orthopaedic Surgery Physician	$0	$2.7M
Sanford Clinic	SD	Family Medicine Physician	$0	$2M
Gustavo Westin	FL	Medical Oncology Physician	$2M	$0

John Simonson — Billing Profile & Reimbursement Data

Sign up for John Simonson — Billing Profile & Reimbursement Data policy alerts

John Simonson — Billing Profile & Reimbursement Data

Sign up for John Simonson — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Frequently Asked Questions

References