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.

Monument Health Network, Inc. (NPI 1770502460)

Field	Value
Entity Type	Organization
Organization	Monument Health Network, Inc.
Address	2140 Junction Avenue
City	Sturgis
State	SD
ZIP	57785
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	July 19, 2006

Payer Source	Total Paid
Medicaid	$162.3K
Medicare	$0

Medicaid: Complete Services Breakdown

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

11 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.	1,300	$60	$77.9K
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.	570	$100	$57.3K
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.	620	$30	$19.7K
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	20	$90	$1.9K
A0425	Ground mileage, per statute mile	70	$20	$1.6K
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	20	$80	$1.3K
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…	20	$50	$1.1K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	20	$60	$870
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	20	$20	$460
98941	The provider applies manipulation to influence joint and neurophysiological function by a variety of techniques and modalities in three to four spinal regions.	10	$10	$120

Showing 1–10 of 11

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

Monument Health Network, Inc. — 0 of 11 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

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	30	40	270	$180	$281.6K
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.	33	60	680	$60	$205.7K
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	34	30	300	$150	$195.3K
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…	67	70	400	$40	$172.5K
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.	29	70	1,150	$50	$155.9K
A0425	Ground mileage, per statute mile	44	60	680	$50	$106.2K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	24	20	210	$50	$104.8K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	31	30	180	$60	$83.1K
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.	21	40	550	$40	$50.2K
98941	The provider applies manipulation to influence joint and neurophysiological function by a variety of techniques and modalities in three to four spinal regions.	137	140	620	$20	$39.3K

Showing 1–10 of 11

Related Providers

Other providers that share a Tax Identification Number (TIN) with Monument Health Network, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$2M
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$1.8M
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$745.7K
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$737.5K
Monument Health Network, Inc.	SD	Family Medicine Physician	$0	$639K
Monument Health Network, Inc.	SD	General Acute Care Hospital	$0	$440.6K
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$357.7K
Rakesh Ponnapureddy	IA	Cardiovascular Disease Physician	$250.8K	$0
Ethan Levine	NY	Clinical Cardiac Electrophysiology Physician	$222.4K	$220
Monument Health Network, Inc.	SD	General Acute Care Hospital	$0	$214.2K

Nearby Providers

Other providers in the same ZIP code as Monument Health Network, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Black Hills Special Services Cooperative	SD	Developmentally Disabled Services Day Training Agency	$0	$33.7M
Black Hills Special Services	SD	Case Management Agency	$0	$551.6K
Action For The Betterment Of The Community	SD	Community/Behavioral Health Agency	$0	$538.1K
Black Hills Counseling LLC	SD	Mental Health Counselor	$0	$491.4K
Black Hills Special Services Cooperative	SD	Case Management Agency	$0	$471.3K
Northern Hills Eye Care, Prof. L.L.C.	SD	Optometrist	$0	$428.4K
Sturgis Chiropractic, P.C.	SD	Chiropractor	$0	$277.3K
City Of Sturgis	SD	Land Ambulance	$174.7K	$35K
Meade School District 46 1	SD	Local Education Agency (LEA)	$0	$196.9K
Tj Loftus Dental P.C.	SD	General Practice Dentistry	$0	$159.8K

Monument Health Network, Inc. — Billing Profile & Reimbursement Data

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Monument Health Network, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References