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.

Wagner Community Memorial Hospital (NPI 1740306992)

Wagner Community Memorial Hospital is a family medicine physician provider located in Wagner, South Dakota. This profile covers 0 Medicare and 22 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	Wagner Community Memorial Hospital
Address	513 3rd St Sw
City	Wagner
State	SD
ZIP	57380
Taxonomy	Family Medicine Physician
NPI Enumerated	March 21, 2007

Payer Source	Total Paid
Medicaid	$499.8K
Medicare	$0

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

22 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…	3,170	$50	$142.6K
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…	820	$70	$59.6K
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.	910	$60	$51K
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.	1,740	$30	$50.4K
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,…	1,840	$30	$49.6K
90834	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…	450	$80	$34.3K
99281	The provider sees a patient for the lowest level emergency department visit.	1,310	$20	$30.1K
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.	300	$100	$29.5K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	170	$130	$21K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	750	$10	$7.5K

Showing 1–10 of 22

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

Wagner Community Memorial Hospital — 0 of 20 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

22 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…	91	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…	133	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.	41	60	680	$60	$205.7K
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…	70	70	200	$80	$176.7K
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.	37	70	1,150	$50	$155.9K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	123	190	430	$90	$154.1K
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,…	24	160	210	$120	$97.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	42	60	170	$90	$66.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	51	160	180	$40	$59.6K
90834	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…	25	80	200	$60	$53.9K

Showing 1–10 of 22

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wagner Community Memorial Hospital	SD	Critical Access Hospital	$0	$768.3K
John Wagener	SD	Interventional Cardiology Physician	$352.5K	$0
Kelly Steffen	SD	Cardiovascular Disease Physician	$276.3K	$0
Tarek Mahrous	SD	Interventional Cardiology Physician	$210.6K	$0
Jonathon Adams	SD	Clinical Cardiac Electrophysiology Physician	$203.1K	$0
Paul Olson	SD	Clinical Cardiac Electrophysiology Physician	$203K	$0
Thomas Waterbury	SD	Interventional Cardiology Physician	$196.1K	$0
Riyad Mohama	SD	Clinical Cardiac Electrophysiology Physician	$168.3K	$0
Christopher Stanton	SD	Clinical Cardiac Electrophysiology Physician	$148.5K	$0
Christopher Paa	SD	Cardiovascular Disease Physician	$148.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wagner Indian Health Service Health Center	SD	Clinic/Center	$0	$8.8M
Rural Office Of Community Services, Inc	SD	Non-emergency Medical Transport (VAN)	$0	$739.4K
Gary Bubak	SD	Internal Medicine Physician	$0	$251.5K
Rural Office Of Community Services Inc	SD	Secured Medical Transport (VAN)	$0	$81.2K
First Chiropractic Centers, PC	SD	Chiropractor	$0	$72.7K
Jay Fitzgerald	SD	Sports Physician Chiropractor	$54K	$0
Avera Mckennan	SD	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$42.2K
Berkley Erickson	SD	Family Nurse Practitioner	$20.3K	$0

Wagner Community Memorial Hospital — Billing Profile & Reimbursement Data

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Wagner Community Memorial Hospital — 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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