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.

Prairie Lakes Health Care System Inc (NPI 1720166002)

Prairie Lakes Health Care System Inc is a rural acute care hospital provider located in Watertown, South Dakota. This profile covers 0 Medicare and 94 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	Prairie Lakes Health Care System Inc
Address	401 9th Ave Nw
City	Watertown
State	SD
ZIP	57201
Taxonomy	Rural Acute Care Hospital
NPI Enumerated	November 2, 2006

Payer Source	Total Paid
Medicaid	$2M
Medicare	$0

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

94 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.	10,310	$50	$484.7K
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.	4,410	$60	$260.1K
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…	7,580	$30	$204.7K
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…	3,000	$50	$158.8K
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…	3,820	$40	$145.2K
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.	3,680	$30	$95.8K
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	640	$110	$68.2K
90961	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the…	740	$90	$63.2K
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,…	2,730	$20	$57.4K
90999	Use 90999 to report dialysis services or procedures that do not have a specific code.	2,820	$20	$50.7K

Showing 1–10 of 94

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

Prairie Lakes Health Care System Inc — 0 of 25 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

94 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90999	Use 90999 to report dialysis services or procedures that do not have a specific code.	15	30	3,520	$50	$769.4K
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…	54	340	1,010	$100	$511K
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	19	40	270	$180	$281.6K
00170	The provider performs anesthesia services for a patient undergoing an intraoral procedure, including biopsy.	18	20	130	$150	$248.6K
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.	17	40	340	$90	$234.9K
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…	43	260	860	$80	$222.6K
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.	10	60	680	$60	$205.7K
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	21	30	300	$150	$195.3K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	53	70	200	$80	$176.7K
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…	19	70	400	$40	$172.5K

Showing 1–10 of 94

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prairie Lakes Health Care System Inc	SD	Rural Acute Care Hospital	$0	$703.4K
Reed Smith	CO	Diagnostic Radiology Physician	$493.2K	$0
Coteau Des Prairies Hospital	SD	Multi-Specialty Clinic/Center	$0	$438.4K
Aaron Gould	IL	Diagnostic Radiology Physician	$126.2K	$209.3K
Trudi Parker	MN	Diagnostic Radiology Physician	$317.2K	$0
Hollis Nipe	SD	Internal Medicine Physician	$246.8K	$0
Michael Rogan	MN	Diagnostic Radiology Physician	$245K	$0
Eric Woolley	SD	Foot & Ankle Surgery Podiatrist	$238.4K	$0
Scott Torness	SD	Foot & Ankle Surgery Podiatrist	$211.2K	$0
Jessica Horn	SD	Family Medicine Physician	$198.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Human Service Agency	SD	Addiction (Substance Use Disorder) Counselor	$0	$39M
Brown Clinic Pllp	SD	Family Medicine Physician	$0	$3.1M
Thane Evans Crump Dds PC	SD	Endodontics	$0	$2.3M
Human Service Agency	SD	Case Management Agency	$0	$2.3M
Sanford Clinic	SD	Family Medicine Physician	$0	$2M
Prairie Lakes Home Connections	SD	Supports Brokerage Agency	$0	$1.2M
Big Stone Therapies Watertown, LLC	SD	Physical Therapy Clinic/Center	$0	$1.1M
City Of Watertown	SD	Land Ambulance	$475.4K	$390.4K
Bridgeway Counseling Center Inc.	SD	Psychologist	$0	$813.1K
Chad D. Beynon, O.d., P.C.	SD	Optometrist	$0	$630.8K

Prairie Lakes Health Care System Inc — Billing Profile & Reimbursement Data

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Prairie Lakes Health Care System Inc — 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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