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 Rapid City Hospital, Inc. (NPI 1821477746)

Key Findings

Field	Value
Entity Type	Organization
Organization	Monument Health Rapid City Hospital, Inc.
Address	640 Flormann St
City	Rapid City
State	SD
ZIP	57701
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	May 26, 2015

Payer Source	Total Paid
Medicaid	$5.2M
Medicare	$0

This provider reports no Medicare billing on file and is effectively a Medicaid-focused operation with total Medicaid revenue of $5.2M. The absence of Medicare activity makes the provider single-payer–concentrated at present, which concentrates reimbursement exposure to Medicaid policy and rates rather than a mixed Medicare/Medicaid risk profile.

Revenue concentration is significant: the precomputed top 3 Medicaid codes by revenue account for 45.6% of the provider's total Medicaid revenue. Those three codes are 99214 ($918.3K, 18.3%), 99232 ($732.5K, 14.6%), and 90961 ($631.9K, 12.6%), indicating a small set of services drive nearly half of Medicaid receipts.

The code mix points to a combined hospital and chronic renal care operation. High revenues for dialysis and ESRD management codes (90961 $631.9K, 90960 $487.8K, 90962 $113.2K and hemodialysis 90935 $188.8K) alongside substantial inpatient E/M codes (99232 $732.5K; 99231 $175.6K; 99233 $160.7K) suggest on-site dialysis services integrated with inpatient and observation care.

Outpatient ambulatory care is also a material service line: 99214 ($918.3K) and 99215 ($338.5K) are both among the top contributors, and 99213 ($326.2K) further underscores high-volume established-patient office visits. These visit-level revenues, together with high volumes of lab and phlebotomy codes (36415: 10.1K claims, $50.6K; 84443: 3.4K claims, $51.1K; 80053: 4.7K claims, $47.3K), are consistent with ongoing chronic disease management and ambulatory follow-up.

State-level competitive standing is strong in dialysis/ESRD services: 90961 ranks #1 of 12 providers in-state (100th percentile) and is labeled notably above typical state volume, while 90960 ranks #2 of 12 (91th percentile) and 90935 ranks #1 of 7 (100th percentile). The provider also posts above-typical volume for outpatient E/M—99214 ranks #6 of 260 (98th percentile) and 99215 ranks #3 of 71 (97th percentile)—positioning it as a major in-state provider for those service lines.

The provider shows meaningful inpatient/consult presence beyond dialysis, with consult/inpatient codes such as 99254 ($141.6K, #2 of 8 in-state) and initial inpatient 99222 ($48.4K, #6 of 53) appearing in the top code list. These entries indicate the organization manages both complex inpatient evaluations and ongoing inpatient follow-up care rather than only ambulatory visits.

There are also notable skilled-nursing and facility-based services: 99309 (subsequent nursing facility visit) appears with $71.2K revenue and ranks #2 of 43 in-state (98th percentile), signaling a strong presence in post-acute or SNF follow-up activity. Combined with high 99231–33 volumes, this reinforces a care continuum that spans inpatient, post-acute, and ambulatory settings.

The provider has an established enrollment history with an NPI enumeration date of 2015-05-26 (~11 years ago), indicating it has had time to develop regional referral patterns and the dialysis/inpatient infrastructure reflected in the claims mix. Given the Medicaid-only revenue base and the high concentration in a few codes (top 3 = 45.6%), payers should note both the provider's specialty strength in ESRD/dialysis and the financial sensitivity that arises from a concentrated payer and code mix.

Medicaid: Complete Services Breakdown

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

96 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…	21,360	$40	$918.3K
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…	18,780	$40	$732.5K
90961	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the…	6,450	$100	$631.9K
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	4,780	$100	$487.8K
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…	4,340	$80	$338.5K
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…	9,890	$30	$326.2K
90935	Hemodialysis is a procedure that involves drawing blood via an intra–arterial or intravenous catheter, then sieving it through a semi permeable membrane to remove the impurities and finally…	4,840	$40	$188.8K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	6,760	$30	$175.6K
W0037	N/A	5,220	$30	$172.3K
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…	2,920	$60	$160.7K

Showing 1–10 of 96

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 Rapid City Hospital, Inc. — 9 of 25 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

96 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…	44	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…	6	260	860	$80	$222.6K
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…	7	70	400	$40	$172.5K
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…	8	40	250	$50	$151.7K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	41	40	160	$90	$116.9K
99254	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider spends…	2	10	330	$130	$99.7K
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…	3	70	130	$100	$99K
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,…	100	160	210	$120	$97.4K
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	2	10	70	$80	$94.3K
99205	The provider sees a new 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 provider…	8	20	150	$100	$83.7K

Showing 1–10 of 96

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Behavior Management Systems, Inc.	SD	Community/Behavioral Health Agency	$0	$19.8M
Community Health Center Of The Black Hills Inc	SD	Federally Qualified Health Center (FQHC)	$0	$10.2M
Jrk Services, Inc	SD	Home Health Agency	$0	$10.1M
Black Hills Pediatrics, LLP	SD	Pediatrics Physician	$0	$9.7M
Rapid City Emergency Services PA	SD	Emergency Medicine Physician	$0	$8.2M
Wellspring Inc.	SD	Psychiatry Physician	$0	$7.4M
Prema Abraham	SD	Retina Specialist (Ophthalmology) Physician	$7.1M	$0
Radiology Associates Prof, LLC	SD	Diagnostic Radiology Physician	$0	$5.3M
City Of Rapid City	SD	Ambulance	$1.4M	$3.7M
Rapid City Medical Center, LLP	SD	Multi-Specialty Clinic/Center	$0	$4.5M

Monument Health Rapid City Hospital, Inc. — Billing Profile & Reimbursement Data

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Monument Health Rapid City Hospital, Inc. — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Monument Health Rapid City Hospital, Inc	SD	Multi-Specialty Clinic/Center	$0	$18.7M
Monument Health Rapid City Hospital, Inc.	SD	General Acute Care Hospital	$0	$11.5M
Richard White	AR	Hematology & Oncology Physician	$2.2M	$0
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$2M
Jennifer May	SD	Internal Medicine Physician	$1.9M	$0
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$1.8M
Monument Health Rapid City Hospital, Inc.	SD	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.6M
Luke Hushagen	SD	Internal Medicine Physician	$1.4M	$0
Don Wynn	TX	Pulmonary Disease Physician	$1.4M	$0
Monument Health Rapid City Hospital, Inc.	SD	Urgent Care Clinic/Center	$0	$1.3M