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 Nebraska for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Nebraska 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. Nebraska (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.

Grand Island Clinic Inc (NPI 1598766735)

Key Findings

Field	Value
Entity Type	Organization
Organization	Grand Island Clinic Inc
Address	2444 W Faidley Ave
City	Grand Island
State	NE
ZIP	68803
Taxonomy	Family Medicine Physician
NPI Enumerated	August 10, 2005

Payer Source	Total Paid
Medicaid	$9.2M
Medicare	$0

This provider is effectively single‑payer in the available data: there is no Medicare billing on file while total Medicaid revenue is $9.2M, indicating the clinic’s entire documented federal reimbursement footprint in our dataset comes from Medicaid. Analysts should treat Medicaid as the primary payer when evaluating revenue risk and network positioning for this entity.

Revenue is highly concentrated in a small set of outpatient evaluation-and-management and preventive codes: the precomputed top 3 Medicaid codes account for 66.3% of this provider’s Medicaid revenue, driven by 99213 ($3.3M, 36.7%), 99214 ($1.4M, 15.7%), and 99391 ($1.3M, 14.0%). This concentration shows the practice’s financial reliance on routine established-patient visits and preventive adult visits rather than procedural or specialty services.

The code mix and volumes point to a high-throughput family medicine practice focused on primary care and preventive services: 99213 has 51.5K claims ($64 avg paid/claim) and 99214 has 14.7K claims ($96 avg paid/claim), while pediatric and preventive visit codes such as 99391 (13.5K claims, $93 avg) and 99392 (9.8K claims, $99 avg) also produce material revenue. Together, these volumes suggest sustained scheduling capacity for same-day/established visits and a strong emphasis on routine wellness visits and immunizations.

Competitive standing in-state is strong for several core codes: 99213 ranks #11 of 696 providers in Nebraska (99th percentile) and 99391 ranks #4 of 69 providers in-state (96th percentile), both labeled notably above typical state volume. By contrast, 99214 ranks #25 of 596 (96th percentile) and is described as typical/unremarkable volume for that code, indicating the provider is unusually busy at lower-complexity established visits but more typical at moderate-complexity visits.

There are clear testing and immunization service lines operating at elevated state levels: 87502 (multiplex influenza NAAT) ranks #2 of 65 providers (98th percentile) and is labeled an extreme outlier, and 87635 (SARS‑CoV‑2 NAAT) ranks #3 of 104 providers (98th percentile) with the same extreme outlier label. Multiple vaccine codes (90686, 90648, 90670, 90723, 90716, 90707) also rank notably above typical state volume, indicating a sizable on-site immunization program that complements preventive visits.

Operational workflows appear to include in-house lab and screening capacity: 36415 has 14.3K claims ($4 avg paid/claim) and 87651 (Strep A NAAT) has 4.1K claims ($33 avg paid/claim), while rapid antigen/visual assays such as 87804 and 87880 also appear in the top codes. These volumes imply routine point-of-care testing and specimen collection are integrated into the clinic’s visit flow, supporting high patient throughput and same‑visit diagnostics.

Pediatric and adolescent preventive care is a distinct practice focus: pediatric well-visit codes 99393 (3.4K claims, $326.7K), 99392 (9.8K claims, $969K), and adolescent code 99394 (1.9K claims, $197.6K) together contribute materially to Medicaid revenue and rank in high percentiles in-state. The combination of those well-visit volumes with multiple pediatric vaccine codes (90681, 90633, 90648, 90707) indicates a sustained pediatric/adolescent patient panel and immunization throughput.

The provider shows institutional longevity that supports its Medicaid position: the NPI was enumerated on 2005-08-10 (~21 years ago), suggesting a long-established practice presence in Grand Island, NE. That tenure is consistent with the clinic’s high in-state ranks on several primary-care and testing codes and implies durable referral and payer relationships within the state Medicaid market.

Medicaid: Complete Services Breakdown

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

83 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…	51,490	$60	$3.3M
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…	14,680	$100	$1.4M
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…	13,540	$90	$1.3M
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…	9,790	$100	$969K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	3,400	$100	$326.7K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	2,940	$90	$270.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1,920	$100	$197.6K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	3,940	$50	$193K
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…	10,020	$20	$170.3K
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.	4,100	$30	$135.3K

Showing 1–10 of 83

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Nebraska providers billing the same CPT/HCPCS codes.

Claims Volume vs. Nebraska Distribution

Grand Island Clinic Inc — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nebraska

Full comparison — all codes billed, vs. Nebraska median

83 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…	11	700	660	$70	$305.1K
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…	25	600	610	$70	$251.4K
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…	4	70	360	$80	$234.7K
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…	5	70	230	$90	$222.7K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	17	30	1,720	$10	$158.7K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	12	30	290	$70	$143.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	6	70	100	$100	$100.9K
94640	The provider administers oxygen under pressure or not under pressure to open obstructed air passages. He uses any of the listed devices to treat a patient with an acute obstruction of the airway that…	18	30	440	$60	$99.6K
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.	87	130	1,410	$10	$69.2K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	58	100	190	$20	$55.3K

Showing 1–10 of 83

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
David Hadford	NE	Diagnostic Radiology Physician	$323.3K	$0
Cody Evans	NE	Diagnostic Radiology Physician	$308.9K	$0
Amanda Dimmitt	NE	Diagnostic Radiology Physician	$287.6K	$0
Nathan Murdoch	NE	Diagnostic Radiology Physician	$263.6K	$0
Aaron Benner	NE	Diagnostic Radiology Physician	$237.7K	$0
Joseph Vavricek	IA	Diagnostic Radiology Physician	$207.9K	$0
Daniel Novinski	NE	Diagnostic Radiology Physician	$192.5K	$0
Alyssa Plouzek	MO	Diagnostic Radiology Physician	$99.1K	$0
Douglas Herbek	NE	Family Medicine Physician	$67.2K	$0
Adam Brosz	NE	Family Medicine Physician	$47K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Go Physical Therapy, LLC	NE	Physical Therapist	$0	$12.4M
Saint Francis Medical Center	NE	General Acute Care Hospital	$0	$11M
Mid-plains Center For Behavioral Healthcare Services, Inc.	NE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$10M
Heartland Health Center, Inc.	NE	Federally Qualified Health Center (FQHC)	$0	$8.8M
Midwest Emergency Grand Island Inc	NE	Emergency Medicine Physician	$0	$3.8M
Active Family Chiropractic And Acupuncture PC	NE	Chiropractor	$0	$3.8M
Twin Rivers Urgent Care LLC	NE	Family Medicine Physician	$0	$2.9M
Family Practice Of Grand Island P C	NE	Family Medicine Physician	$0	$2.2M
Ryan Ramaekers	NE	Hematology & Oncology Physician	$2.1M	$0
Wholeness Healing Center PC	NE	Mental Health Counselor	$0	$2.1M

Grand Island Clinic Inc — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References