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.

Avera Queen Of Peace (NPI 1699972422)

Field	Value
Entity Type	Organization
Organization	Avera Queen Of Peace
Address	625 N Foster St Ste 200
City	Mitchell
State	SD
ZIP	57301
Taxonomy	Specialist
NPI Enumerated	June 27, 2007

Payer Source	Total Paid
Medicaid	$198.3K
Medicare	$0

Medicaid: Complete Services Breakdown

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

7 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…	2,150	$30	$70.8K
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…	1,080	$50	$58.3K
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…	580	$60	$33.2K
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…	370	$90	$33K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	80	$30	$2.5K
73110	The provider takes at least three X–ray images of a patient’s complete wrist to check for any fracture, swelling, or reason of pain in the wrist area.	30	$10	$320
73564	In this procedure, the provider takes four or more X–ray views of the knee joint to check for any fracture, swelling, or reason for pain in the knee area.	20	$10	$140

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

Avera Queen Of Peace — 0 of 7 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

7 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…	115	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…	148	260	860	$80	$222.6K
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…	22	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…	26	80	120	$80	$61.5K
73110	The provider takes at least three X–ray images of a patient’s complete wrist to check for any fracture, swelling, or reason of pain in the wrist area.	14	20	370	$10	$16.6K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	10	20	80	$30	$15.9K
73564	In this procedure, the provider takes four or more X–ray views of the knee joint to check for any fracture, swelling, or reason for pain in the knee area.	9	10	390	$10	$8.1K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Avera Queen Of Peace, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Avera Mckennan	SD	Diagnostic Radiology Physician	$0	$3.3M
Avera Mckennan	SD	Maternal & Fetal Medicine Physician	$0	$2.3M
Ayham Deeb	VA	Hematology & Oncology Physician	$1.9M	$0
Avera Mckennan	SD	Pediatrics Physician	$0	$1.4M
Avera Queen Of Peace	SD	Critical Access Hospital	$0	$1.3M
Kathleen Naegele	IL	Hematology & Oncology Physician	$805.1K	$57.9K
Avera Queen Of Peace	SD	Rural Acute Care Hospital	$0	$803.8K
Abbas Chamsuddin	IL	Diagnostic Radiology Physician	$368.8K	$114.2K
Neil Bansal	NJ	Neuroradiology Physician	$351.9K	$0
Avera Queen Of Peace	SD	Clinical Medical Laboratory	$0	$286.7K

Nearby Providers

Other providers in the same ZIP code as Avera Queen Of Peace, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lifequest	SD	Developmentally Disabled Services Day Training Agency	$0	$53.1M
Abbott House, Inc.	SD	Psychiatric Residential Treatment Facility	$0	$28.1M
Lifequest	SD	Case Manager/Care Coordinator	$0	$13.2M
Dakota Counseling Institute, Inc.	SD	Mental Health Counselor	$0	$9.7M
Dakota Solace Home Care	SD	In Home Supportive Care Agency	$0	$4.9M
Rural Health Care, Inc	SD	Federally Qualified Health Center (FQHC)	$0	$4.4M
Rosewood Court	SD	Assisted Living Facility	$0	$2.7M
Sanford Clinic	SD	Obstetrics & Gynecology Physician	$0	$1.2M
Dpt Inc	SD	Home Health Agency	$0	$835.1K
Mitchell Clinic Ltd	SD	Family Medicine Physician	$0	$619.4K

Avera Queen Of Peace — Billing Profile & Reimbursement Data

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Avera Queen Of Peace — 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