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 Minnesota for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Minnesota 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. Minnesota (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.

Park Nicollet Clinic (NPI 1780621904)

Key Findings

Field	Value
Entity Type	Organization
Organization	Park Nicollet Clinic
Address	3800 Park Nicollet Blvd
City	St Louis Park
State	MN
ZIP	55416
Taxonomy	Family Medicine Physician
NPI Enumerated	May 31, 2006

Payer Source	Total Paid
Medicaid	$210M
Medicare	$0

This entity reports no Medicare billing on file and $210M in lifetime Medicaid revenue, making its operational footprint effectively single‑payer (Medicaid) in scale rather than split across Medicare and Medicaid. Analysts should treat Medicaid reimbursement policy and enrollment shifts as first‑order drivers of the provider’s revenue exposure.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 55.3% of the provider’s total Medicaid revenue, driven primarily by 99214 (28.0%), 99213 (21.3%), and S0302 (6.0%). This concentration indicates that a small set of ambulatory E/M and EPSDT service lines dominate the financial profile.

The code mix and top revenue drivers indicate a large, high‑volume primary care operation focused on established outpatient visits: 99214 appears with 559.9K claims and $39.2M revenue, and 99213 appears with 606.7K claims and $29.7M revenue. These volumes and dollar amounts — combined with these codes’ role as the top two revenue sources — suggest routine office‑based evaluation and management for a broad patient panel is the core service line.

Pediatric and preventive care are significant components of activity: S0302 (EPSDT) accounts for $8.4M and ranks as an extreme outlier in-state, and preventive E/M codes (99392, 99391, 99393) and vaccine administration (90460, 118.8K claims, $2.7M) also appear materially in the top code list. Together these codes and high vaccine/child‑visit claim counts indicate sizable throughput for well‑child services and age‑based preventive programs.

The provider is a dominant Medicaid competitor statewide for many key codes: 99214 and 99213 both rank #1 in-state at the 100th percentile and are described as extreme outliers, and S0302 also ranks #1 at the 100th percentile. Multiple other codes show 100th‑percentile rankings or similarly extreme standing, signaling market leadership in outpatient primary care and related services within Minnesota Medicaid.

The broader CPT mix shows integrated ambulatory capabilities beyond core E/M visits — examples include ophthalmology evaluations (92014, $2.9M; 92004, $2.7M), behavioral health psychotherapy (90834, $3.6M; 90837, $1.6M), physical/occupational modalities (97110, $2.8M; 97530, $1.7M), and high‑volume specimen collection (36415, 406.1K claims, $1.6M). This breadth of high‑volume ancillary services implies an on‑site or closely coordinated set of outpatient specialties and support services that extend revenue beyond basic office visits.

Claim volumes across many top codes are unusually large — for example, 606.7K claims for 99213, 559.9K claims for 99214, and 406.1K claims for 36415 — reinforcing the picture of a very high‑throughput ambulatory system. Where rank labels indicate "extreme outlier" or the 100th percentile, these volumes are well above typical in‑state patterns and reflect concentrated scale rather than marginal participation.

The practice has long tenure in the NPI registry (enumerated 2006-05-31, ~20 years ago), signaling an established presence in the market. That longevity coupled with a Medicaid‑only revenue base ($210M and no Medicare billing on file) means strategic or policy changes affecting Medicaid reimbursement or enrollment would likely have outsized impact on the provider’s financial and operational performance.

Medicaid: Complete Services Breakdown

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

591 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	559,920	$70	$39.2M
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…	606,680	$50	$29.7M
S0302	Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)	156,000	$50	$8.4M
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	62,680	$90	$5.6M
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…	72,060	$60	$4.5M
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…	45,850	$100	$4.4M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	59,520	$70	$4M
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…	65,240	$60	$3.6M
X5622	N/A	72,360	$50	$3.3M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	54,510	$60	$3.1M

Showing 1–10 of 591

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Minnesota providers billing the same CPT/HCPCS codes.

Claims Volume vs. Minnesota Distribution

Park Nicollet Clinic — 22 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. Minnesota median

591 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	Injection, aflibercept, 1 mg	4	10	80	$1,620	$1.9M
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	3	10	260	$900	$836.6K
T1013	Sign language or oral interpretive services, per 15 minutes	16	210	560	$60	$822.1K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	10	120	400	$60	$685.8K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	20	50	310	$130	$678K
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…	1	1,180	1,150	$80	$605.7K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	10	110	1,880	$50	$564.6K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	37	100	510	$40	$560.8K
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…	1	1,200	1,030	$70	$549.7K
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…	63	1,140	1,010	$100	$543K

Showing 1–10 of 591

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Park Nicollet Methodist Hospital	MN	General Acute Care Hospital	$0	$17.2M
Tria Orthopaedic Center LLC	MN	Orthopaedic Surgery Physician	$0	$7.3M
Mehdi Najafi	MA	Ophthalmology Physician	$1.8M	$0
Marni Feldmann	MN	Retina Specialist (Ophthalmology) Physician	$1.7M	$0
Peter Kent	MN	Rheumatology Physician	$1.6M	$0
Yang Liu	MN	Hematology & Oncology Physician	$1.4M	$0
Elizabeth Miller	MN	Rheumatology Physician	$1.3M	$0
Bethel Averbeck	MN	Internal Medicine Physician	$1.2M	$0
Paul Drayna	MN	Retina Specialist (Ophthalmology) Physician	$1M	$0
Shawn Ronan	MN	Retina Specialist (Ophthalmology) Physician	$909.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tactile Systems Technology, Inc	MN	Durable Medical Equipment & Medical Supplies	$0	$97.5M
Associated Clinic Of Psychology Inc	MN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$72.7M
Blue & White Service Corporation	MN	Taxi	$0	$39M
Iska Inc	MN	Developmentally Disabled Services Day Training Agency	$0	$10.8M
Caring Sisters Home Care Services, Inc	MN	Assisted Living Facility	$0	$8.8M
The Wayside House, Inc	MN	Substance Abuse Rehabilitation Facility	$0	$7.9M
Medical Scanning Consultants PA	MN	Diagnostic Radiology Physician	$0	$7.5M
Life Medical, P.A.	MN	Multi-Specialty Clinic/Center	$0	$4.6M
Surgicare Of Minneapolis Ltd	MN	Ambulatory Surgical Clinic/Center	$1.4M	$0
Artan Kaso	MN	Internal Medicine Physician	$850.6K	$0

Park Nicollet Clinic — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References