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.

Fall River Health Services (NPI 1679544555)

Field	Value
Entity Type	Organization
Organization	Fall River Health Services
Address	1201 Hwy 71 South
City	Hot Springs
State	SD
ZIP	57747
Taxonomy	Critical Access Hospital
NPI Enumerated	January 30, 2006

Payer Source	Total Paid
Medicaid	$303.3K
Medicare	$0

Medicaid: Complete Services Breakdown

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

13 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.	2,380	$50	$114.2K
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.	2,360	$40	$94.4K
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.	590	$60	$34.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	330	$90	$29.8K
C9803	Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	300	$70	$19.8K
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.	190	$30	$5.3K
A9270	Non-covered item or service	250	$10	$3K
87634	The lab analyst performs a test for respiratory syncytial virus (RSV) antigen detection using amplified nucleic acid probe technique.	10	$160	$1.9K
U0002	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	290	$1	$290
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.	20	$20	$260

Showing 1–10 of 13

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

Fall River Health Services — 0 of 10 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

13 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.	8	40	340	$90	$234.9K
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.	31	60	680	$60	$205.7K
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.	22	70	1,150	$50	$155.9K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	68	110	990	$20	$82.9K
A9270	Non-covered item or service	21	30	1,140	$20	$80.5K
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.	29	40	550	$40	$50.2K
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.	56	70	920	$20	$33.8K
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…	72	80	920	$10	$22.5K
U0002	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	8	30	180	$40	$22.1K
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.	80	80	210	$30	$18K

Showing 1–10 of 13

Related Providers

Other providers that share a Tax Identification Number (TIN) with Fall River Health Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Fall River Health Services	SD	Rural Health Clinic/Center	$0	$1.4M
Lauren Buyan	SD	Emergency Medicine Physician	$114.9K	$0
John Misdary	SD	Emergency Medicine Physician	$114K	$0
Alexander Brech	SD	Emergency Medicine Physician	$114K	$0
John Hill	SD	Emergency Medicine Physician	$113.3K	$0
Michael Frost	SD	Emergency Medicine Physician	$110.3K	$0
Jed Christensen	SD	Emergency Medicine Physician	$109.2K	$0
Kirsten Busse	SD	Emergency Medicine Physician	$107.6K	$0
Brook Eide	SD	Emergency Medicine Physician	$88.4K	$0
Patrick Tibbles	SD	Emergency Medicine Physician	$80.7K	$0

Nearby Providers

Other providers in the same ZIP code as Fall River Health Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Monument Health Network, Inc.	SD	Rural Health Clinic/Center	$0	$324.1K
Hot Springs Ambulance Service	SD	Land Ambulance	$264.2K	$53.5K
Wilkinson Vision, Inc	SD	Optometrist	$0	$195.2K
Cascade Chiropractic Of South Dakota	SD	Chiropractor	$0	$147.1K
Massa Dental Offices, PC	SD	General Practice Dentistry	$0	$132.3K
Dallas Wilkinson	SD	Optometrist	$70.1K	$0
Catherine Wilson	SD	Certified Registered Nurse Anesthetist	$52.1K	$0
Brad Fischer	SD	Physical Therapist	$51.9K	$0
Shannon Deboer	SD	Chiropractor	$50.1K	$0
Dakotamart Inc	SD	Community/Retail Pharmacy	$30.9K	$0

Fall River Health Services — Billing Profile & Reimbursement Data

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Fall River Health Services — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References