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.

Dunes Anesthesia PC (NPI 1801810585)

Dunes Anesthesia PC is a pain medicine (anesthesiology) physician provider located in Dakota Dunes, South Dakota. This profile covers 0 Medicare and 13 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	Dunes Anesthesia PC
Address	101 Tower Rd
City	Dakota Dunes
State	SD
ZIP	57049
Taxonomy	Pain Medicine (Anesthesiology) Physician
NPI Enumerated	July 27, 2006

Payer Source	Total Paid
Medicaid	$1.1M
Medicare	$0

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

13 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…	25,060	$20	$551.4K
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…	16,740	$30	$535.6K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	540	$50	$26.5K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	2,600	$10	$18.2K
27096	The provider performs an injection in the joint between the sacrum and ilium on one side of the body, with the aid of imaging equipment to locate the injection site. He injects an anesthetic to…	40	$80	$3.2K
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,…	290	$10	$3.2K
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…	30	$70	$1.9K
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…	60	$20	$1.2K
29200	The provider applies elastic adhesive tape to the thorax, or chest, to hold the muscles in a fixed position and limit excessive or abnormal movements. Strapping treats muscle strains, dislocations,…	50	$20	$1K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	50	$10	$510

Showing 1–10 of 13

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

Dunes Anesthesia PC — 2 of 13 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

13 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…	12	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…	9	260	860	$80	$222.6K
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,…	70	160	210	$120	$97.4K
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…	63	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…	63	80	120	$80	$61.5K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	6	20	70	$50	$23.8K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	2	10	520	$10	$14.3K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	40	70	60	$50	$13.8K
76942	Ultrasonography uses sound waves of higher frequencies (above the normal hearing capacity of a healthy human, i.e., 20 kHz) to visualize inner organs. When the sound waves pass through the human…	6	10	120	$30	$7.2K
27096	The provider performs an injection in the joint between the sacrum and ilium on one side of the body, with the aid of imaging equipment to locate the injection site. He injects an anesthetic to…	2	10	40	$110	$5.5K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Christopher Price	NE	Anesthesiology Physician	$144.6K	$0
James Bertus	NE	Pain Medicine Physician	$136.3K	$0
David King	SD	Physician Assistant	$126.6K	$0
Wade Lukken	SD	Anesthesiology Physician	$115.7K	$0
Frederick Fisher	SD	Pain Medicine (Anesthesiology) Physician	$96.1K	$0
Dustin Sorenson	SD	Anesthesiology Physician	$78.1K	$0
Jeremy Poulsen	SD	Pain Medicine (Anesthesiology) Physician	$75.6K	$0
David Welch	SD	Surgical Physician Assistant	$74.8K	$0
Meredith Hunhoff	SD	Family Nurse Practitioner	$72.7K	$0
Stephanie Wortman	NE	Family Nurse Practitioner	$68.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cnos PC	SD	Orthopaedic Surgery Physician	$0	$3.6M
Dunes Dental 4 Kids, LLP	SD	Pediatric Dentistry	$0	$3.3M
Chad Laurich	SD	Vascular Surgery Physician	$3.2M	$0
Liem Som Oei Md PC	SD	Nephrology Physician	$0	$2.4M
Ear Nose And Throat Consultants And Hearing Services Plc	SD	Otolaryngology Physician	$0	$2.2M
Oral Surgery Assocates, P.C.	SD	Oral and Maxillofacial Surgery (Dentist)	$0	$2.1M
Midlands Clinic, P.C.	SD	Specialist	$0	$822.9K
Dunes Medical Laboratories	SD	Clinical Medical Laboratory	$303K	$416.6K
Beth Bruening	SD	Ophthalmology Physician	$704.9K	$2.2K
Neal Khurana	SD	Vascular & Interventional Radiology Physician	$704.3K	$0

Dunes Anesthesia PC — Billing Profile & Reimbursement Data

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Dunes Anesthesia PC — 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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