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

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

Southwest Health System Inc (NPI 1649241571)

Southwest Health System Inc is a critical access hospital provider located in Cortez, Colorado. This profile covers 0 Medicare and 91 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	Southwest Health System Inc
Address	1311 N Mildred Rd
City	Cortez
State	CO
ZIP	81321
Taxonomy	Critical Access Hospital
NPI Enumerated	January 30, 2006

Payer Source	Total Paid
Medicaid	$9.2M
Medicare	$0

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

91 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	28,820	$100	$3M
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.	18,550	$110	$2.1M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	11,760	$150	$1.7M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	2,490	$240	$587.6K
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.	7,570	$60	$454.3K
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.	22,330	$10	$290.3K
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…	2,080	$70	$153.8K
S5161	Emergency response system; service fee, per month (excludes installation and testing)	3,160	$40	$120.2K
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…	1,960	$50	$99.9K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	1,280	$60	$78.3K

Showing 1–10 of 91

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Southwest Health System Inc — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

91 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	36	210	730	$120	$966.7K
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.	27	290	1,390	$110	$958.7K
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	59	130	750	$140	$957.7K
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.	34	270	1,290	$100	$937.1K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	20	70	410	$250	$881.6K
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	83	120	700	$120	$843.2K
A0425	Ground mileage, per statute mile	101	280	990	$20	$636.8K
S5161	Emergency response system; service fee, per month (excludes installation and testing)	26	50	3,160	$40	$382.1K
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…	2,251	2,520	330	$100	$352K
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…	22	80	830	$70	$274.8K

Showing 1–10 of 91

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southwest Health System, Inc.	CO	Rural Health Clinic/Center	$0	$9.4M
Southwest Health System, Inc.	CO	Rural Health Clinic/Center	$0	$5.5M
Timothy Bender	VA	Diagnostic Radiology Physician	$329.1K	$0
Southwest Health System, Inc.	CO	Pharmacy	$135.4K	$0
Matthew Geter	NM	Diagnostic Radiology Physician	$130.3K	$0
Rachel Chaney	CO	Cardiovascular Disease Physician	$121K	$0
Kurt Rohren	CO	Diagnostic Radiology Physician	$119.3K	$0
Timothy Brown	AR	Diagnostic Radiology Physician	$119.3K	$0
Brett Englund	CO	Diagnostic Radiology Physician	$111.9K	$0
Jay Johnson	CO	Diagnostic Radiology Physician	$106.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pasco/sw Inc	CO	Home Health Agency	$0	$6.1M
Angelic Hands Inc.	CO	Home Health Agency	$0	$5.5M
Angelic Hands LLC	CO	Personal Care Attendant	$0	$5.2M
Park Point Healthcare LLC	CO	In Home Supportive Care Agency	$0	$4.9M
Angelic Hands, Inc	CO	In Home Supportive Care Agency	$0	$4.3M
Megan Flesch	CO	Physical Therapist	$260.3K	$0
Braden Jones	CO	Orthopaedic Surgery Physician	$105.6K	$0
Michael Grajeda	CO	Physical Therapist	$103.1K	$0
David Buckwalter	CO	Emergency Medicine Physician	$81.3K	$0
Najib Johnson	CO	Physical Therapist	$77.6K	$0

Southwest Health System Inc — Billing Profile & Reimbursement Data

Sign up for Southwest Health System Inc — Billing Profile & Reimbursement Data policy alerts

Southwest Health System Inc — Billing Profile & Reimbursement Data

Sign up for Southwest Health System Inc — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References