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.

Sanford Health Of Northern Minnesota (NPI 1801870191)

Key Findings

Field	Value
Entity Type	Organization
Organization	Sanford Health Of Northern Minnesota
Address	1300 Anne St Nw
City	Bemidji
State	MN
ZIP	56601
Taxonomy	Rural Acute Care Hospital
NPI Enumerated	December 1, 2005

Payer Source	Total Paid
Medicaid	$47.6M
Medicare	$0

SANFORD HEALTH OF NORTHERN MINNESOTA has no Medicare billing on file and is effectively a single‑payer Medicaid operation for the data shown, reporting $47.6M in lifetime Medicaid revenue and no recorded Medicare revenue. This payer mix means the facility’s financial footprint in public payers is concentrated entirely in Medicaid, rather than split between Medicare and Medicaid.

Revenue is highly concentrated in just a few outpatient and ED services: the top three Medicaid codes account for 81.7% of this provider’s total Medicaid revenue, driven mainly by G0463, 99285, and 99283. That concentration indicates the organization’s Medicaid revenue depends heavily on a small set of high‑volume visit codes rather than a broad mix of inpatient or specialty procedures.

G0463 (Hospital outpatient clinic visit for assessment and management) dominates the Medicaid mix with 311.5K claims and $27.7M revenue, representing 61.8% of the provider’s Medicaid revenue and ranking #4 of 81 in-state (96th percentile). This shows the hospital is operating a very high-volume outpatient clinic function on Medicaid, making clinic visits the single largest revenue driver.

Emergency department care is the second major service line: 99285 (12K claims, $4.6M) and 99283 (25.2K claims, $4.4M) together account for a substantial share of Medicaid revenue (10.2% and 9.8% respectively) and rank in the upper state percentiles (99285 at 84th, 99283 at 91st). Despite being high-volume in absolute terms, these ED codes are described as typical or unremarkable relative to peers, suggesting the hospital’s ED activity is consistent with regional patterns rather than uniquely dominant.

Ophthalmology services are an outsized specialty presence: 92014 (14.4K claims, $1.3M) and 92004 (7.4K claims, $651.6K) both rank at the 98th percentile in-state, with 92014 labeled an extreme outlier, far above typical state volume. The combination of high-volume comprehensive eye exam codes and procedure codes like 67028 (1.8K claims, $392.5K) implies a concentrated and unusually large eye care practice embedded within the hospital’s outpatient services.

Several procedure and infusion codes rank highly in-state and point to focused ancillary services: 20611 ranks #2 of 24 (96th percentile) and 0241U ranks #3 of 112 (98th percentile), while infusion/IV push codes such as 96374 (5.3K claims, $719.3K) and 96375 (2.6K claims, $133.9K) appear with healthy volumes. These placements indicate notable capacity for joint procedures and medication administration services that complement the clinic and ED workload.

The provider shows multiple high‑percentile appearances across diverse code groups (outpatient clinic, ED, ophthalmology, procedures), which supports a profile of a rural acute care hospital with broad outpatient and ED throughput rather than a narrow specialty center. At the same time, the extreme reliance on G0463 for the majority of Medicaid revenue exposes the organization to utilization or policy shifts that affect outpatient clinic visit reimbursement.

NPI tenure is long standing—enumerated 2005-12-01 (~21 years ago)—which suggests the entity has established operations in the region. Combined with its top-in-state rankings on several codes (including multiple codes in the 96th–98th percentiles), the hospital appears to be a well‑entrenched local provider with dominant outpatient clinic and ophthalmology volume in the Minnesota Medicaid market.

Medicaid: Complete Services Breakdown

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

264 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	311,510	$90	$27.7M
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.	12,040	$380	$4.6M
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.	25,190	$170	$4.4M
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.	5,450	$290	$1.6M
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	14,440	$90	$1.3M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	5,330	$140	$719.3K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	7,410	$90	$651.6K
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.	4,740	$90	$421.7K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	1,770	$220	$392.5K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	4,550	$80	$341.4K

Showing 1–10 of 264

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

Sanford Health Of Northern Minnesota — 5 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

264 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	4	80	6,550	$80	$4.4M
J0178	Injection, aflibercept, 1 mg	5	10	80	$1,620	$1.9M
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.	27	160	580	$170	$1.8M
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.	60	210	980	$140	$1.7M
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.	21	220	1,730	$120	$1.3M
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…	82	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.	50	100	510	$40	$560.8K
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…	470	1,140	1,010	$100	$543K
D2930	N/A	46	70	610	$170	$518.6K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	167	260	890	$60	$405.3K

Showing 1–10 of 264

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sanford Medical Center Fargo	ND	Family Medicine Physician	$0	$75.9M
Sanford Medical Center	SD	Family Medicine Physician	$0	$68.8M
Sanford Health Of Northern Minnesota	MN	Internal Medicine Physician	$0	$27.2M
Sanford Health Of Northern Minnesota	MN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$15.1M
Gregory Pippin	ND	Otolaryngology Physician	$48.4K	$1.7M
John Watkins	ND	Radiation Oncology Physician	$1M	$0
Jonathan Marshall	NY	Diagnostic Radiology Physician	$761.9K	$4.4K
Myles Mitsunaga	CA	Diagnostic Radiology Physician	$510.8K	$113.9K
Donald Stallman	ND	Diagnostic Radiology Physician	$610.1K	$0
Stephanie Liu	ND	Dermatopathology (Pathology) Physician	$581.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rem North Star, Inc.	MN	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$132.7M
White Earth Band Of Ojibwe	MN	Community/Behavioral Health Agency	$0	$32.6M
Mississippi Headwaters Area Dental Health Center, Inc.	MN	Public Health Dentistry	$0	$11.8M
Independent School District #31	MN	Local Education Agency (LEA)	$0	$8.8M
Gph Beltrami Inc	MN	Assisted Living Facility	$0	$8.1M
Bemidji Ambulance Service, Inc.	MN	Land Ambulance	$995.8K	$6.4M
Choice Therapy, P.A.	MN	Rehabilitation Clinic/Center	$0	$6.2M
Stellher Human Services, Inc.	MN	Community/Behavioral Health Agency	$0	$5.4M
County Of Beltrami	MN	State or Local Public Health Clinic/Center	$0	$5.1M
Northern Minnesota Addiction Wellness Center	MN	Substance Abuse Rehabilitation Facility	$0	$4.5M

Sanford Health Of Northern Minnesota — 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