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.

Midlands Clinic, P.C. (NPI 1649364894)

Midlands Clinic, P.C. is a specialist provider located in Dakota Dunes, South Dakota. This profile covers 0 Medicare and 18 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	Midlands Clinic, P.C.
Address	705 N Sioux Point Rd
City	Dakota Dunes
State	SD
ZIP	57049
Taxonomy	Specialist
NPI Enumerated	October 3, 2006

Payer Source	Total Paid
Medicaid	$822.9K
Medicare	$0

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

18 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…	10,560	$30	$348.3K
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…	2,720	$50	$133.4K
99203	The provider sees a new 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 provider…	1,640	$60	$103K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	1,210	$80	$101.8K
99204	The provider sees a new 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 provider…	380	$90	$35.3K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	630	$50	$29.7K
17110	The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or…	570	$30	$16.5K
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,…	600	$30	$14.9K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	80	$120	$10K
97597	The provider excises devitalized (dead) tissue from an open wound, choosing from a variety of techniques; treatment may include topical application of medicine or materials, wound assessment,…	1,110	$10	$7.8K

Showing 1–10 of 18

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

Midlands Clinic, P.C. — 2 of 18 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

18 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…	41	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…	56	260	860	$80	$222.6K
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…	64	70	400	$40	$172.5K
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,…	46	160	210	$120	$97.4K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	4	10	130	$130	$77.8K
99203	The provider sees a new 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 provider…	19	100	160	$60	$64.4K
99204	The provider sees a new 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 provider…	25	80	120	$80	$61.5K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	5	10	200	$180	$55.8K
17110	The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or…	4	10	180	$60	$29K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	6	10	200	$40	$20.2K

Showing 1–10 of 18

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Michelle Daffer	SD	Dermatology Physician	$362.4K	$0
Alyssa Mrsny	SD	Physician Assistant	$237.3K	$0
Amy Dietrich	SD	Physician Assistant	$159.9K	$0
Jeffrey Michalak	SD	Gastroenterology Physician	$139.3K	$0
Sarah Bligh	SD	Gastroenterology Physician	$96.7K	$0
Paul Johnson	SD	Surgery Physician	$62.7K	$0
Lawrence Volz	SD	Surgery Physician	$45.5K	$0
Craig Nemechek	SD	Surgery Physician	$36.4K	$0
Lori Drea	SD	Medical Physician Assistant	$1.8K	$0
Brenda Van Scoyk	SD	Surgical Physician Assistant	$1.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cnos PC	SD	Orthopaedic Surgery Physician	$0	$3.6M
Dunes Dental 4 Kids, LLP	SD	Pediatric Dentistry	$0	$3.3M
Chad Laurich	SD	Vascular Surgery Physician	$3.2M	$0
Liem Som Oei Md PC	SD	Nephrology Physician	$0	$2.4M
Ear Nose And Throat Consultants And Hearing Services Plc	SD	Otolaryngology Physician	$0	$2.2M
Oral Surgery Assocates, P.C.	SD	Oral and Maxillofacial Surgery (Dentist)	$0	$2.1M
Dunes Anesthesia PC	SD	Pain Medicine (Anesthesiology) Physician	$0	$1.1M
Dunes Medical Laboratories	SD	Clinical Medical Laboratory	$303K	$416.6K
Beth Bruening	SD	Ophthalmology Physician	$704.9K	$2.2K
Neal Khurana	SD	Vascular & Interventional Radiology Physician	$704.3K	$0

Midlands Clinic, P.C. — Billing Profile & Reimbursement Data

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Midlands Clinic, P.C. — 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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