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.

West River Health Services (NPI 1801987904)

Field	Value
Entity Type	Organization
Organization	West River Health Services
Address	401 6th Ave W
City	Lemmon
State	SD
ZIP	57638
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	September 27, 2006

Payer Source	Total Paid
Medicaid	$353.9K
Medicare	$0

Medicaid: Complete Services Breakdown

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…	2,810	$90	$244.5K
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…	660	$80	$53.8K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	750	$40	$27.6K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	110	$70	$7.8K
11721	The provider surgically debrides (debulks or removes) 6 or more abnormal, diseased, or infected nails.	130	$40	$5.7K
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…	110	$50	$5.2K
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,…	70	$70	$4.6K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	60	$50	$3K
W0037	N/A	550	$1	$1.6K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	30	$0	$0

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

West River Health Services — 0 of 9 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…	100	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…	144	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,…	114	160	210	$120	$97.4K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	58	110	990	$20	$82.9K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	99	160	180	$40	$59.6K
W0037	N/A	92	160	690	$20	$50.1K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	34	40	170	$60	$41.7K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	70	70	450	$20	$29.2K
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…	40	60	190	$30	$20.1K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	49	70	210	$20	$14.7K

Showing 1–10 of 13

Related Providers

Other providers that share a Tax Identification Number (TIN) with West River Health Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Arlene Sussman	MN	Diagnostic Radiology Physician	$242.3K	$29.9K
Brian Cromwell	MN	Diagnostic Radiology Physician	$222.2K	$390
Farhad Sani	MN	Diagnostic Radiology Physician	$220.6K	$0
Joseph Rozell	MN	Diagnostic Radiology Physician	$208K	$70
Sergey Shkurovich	MN	Diagnostic Radiology Physician	$162.1K	$0
Kevin Mcdonnell	MN	Diagnostic Radiology Physician	$140.1K	$17K
Julie Shaffrey	MN	Diagnostic Radiology Physician	$150.7K	$2.5K
Joseph Horner	MN	Diagnostic Radiology Physician	$131.7K	$1.4K
Yair Chaya	MN	Diagnostic Radiology Physician	$102.3K	$29K
Charles Henry	MN	Diagnostic Radiology Physician	$114.1K	$14K

Nearby Providers

Other providers in the same ZIP code as West River Health Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Live Center Inc	SD	Developmentally Disabled Services Day Training Agency	$0	$8M
Three Rivers Mental Health And Chemical Dependency Center	SD	Mental Health Counselor	$0	$2.7M
Hands On Health, Inc.	SD	Physical Therapist	$0	$100.7K
Lemmon Emt Association	SD	Ambulance	$72.4K	$0

West River Health Services — Billing Profile & Reimbursement Data

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West River Health Services — 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