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

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

Sauk Prairie Healthcare Inc (NPI 1861466153)

Sauk Prairie Healthcare Inc is a general acute care hospital provider located in Prairie Du Sac, Wisconsin. This profile covers 0 Medicare and 105 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	Sauk Prairie Healthcare Inc
Address	260 26th St
City	Prairie Du Sac
State	WI
ZIP	53578
Taxonomy	General Acute Care Hospital
NPI Enumerated	February 14, 2006

Payer Source	Total Paid
Medicaid	$2.8M
Medicare	$0

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

105 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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,…	5,450	$70	$365K
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…	5,760	$60	$322.6K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	2,850	$110	$302.1K
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.	3,940	$50	$200.9K
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.	3,670	$40	$161.6K
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.	2,580	$60	$154.7K
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…	3,270	$50	$153.8K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	2,250	$60	$143.9K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	5,780	$20	$121.3K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	920	$90	$85K

Showing 1–10 of 105

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wisconsin Distribution

Sauk Prairie Healthcare Inc — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

105 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	74	140	3,200	$160	$1.1M
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.	137	360	1,550	$70	$614.4K
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.	140	430	760	$60	$484.6K
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.	80	190	1,790	$90	$390.9K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	104	140	2,200	$90	$358.4K
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.	147	330	1,350	$60	$338K
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…	124	170	720	$70	$272.7K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	65	80	650	$110	$244.4K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	109	260	3,590	$20	$232.2K
96360	The provider introduces a catheter intravenously for supplementation of fluid and electrolytes for 31 minutes to one hour to treat severe cases of dehydration.	85	110	1,280	$90	$224.5K

Showing 1–10 of 105

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eric Phillippi	WI	Family Medicine Physician	$271.5K	$0
Michael Lamson	WI	Orthopaedic Surgery Physician	$184.5K	$0
Chad Schneider	WI	Internal Medicine Physician	$183.9K	$0
David Marcu	WI	Orthopaedic Surgery Physician	$141.5K	$0
Matthew Hebert	WI	Orthopaedic Surgery Physician	$130.8K	$0
Andrew Ertl	WI	Orthopaedic Surgery Physician	$113.7K	$0
John Mcauliffe	WI	Family Medicine Physician	$105.5K	$0
Kristen Hoskins	WI	Family Nurse Practitioner	$91.1K	$0
Leah Ederer	WI	Family Medicine Physician	$79.4K	$0
Steven Johnson	WI	Family Medicine Physician	$71.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sauk Prairie Ambulance Association	WI	Land Ambulance	$224.2K	$9.1K
Theodore Parins	WI	Surgery Physician	$46.8K	$0
Norbert Straub	WI	Family Medicine Physician	$39.7K	$0
Nathan Grunewald	WI	Urology Physician	$19.1K	$0
Denise Cole-ouzounian	WI	Clinical Nurse Specialist	$15.1K	$0
David Sisbach	WI	Certified Registered Nurse Anesthetist	$12.4K	$0
Angela Sorg	WI	Nurse Practitioner	$12K	$0
Tara Mahoney	WI	Certified Registered Nurse Anesthetist	$12K	$0
Curtis Johnson	WI	Certified Registered Nurse Anesthetist	$10.3K	$0
Bryant Kearney	WI	Surgical Physician Assistant	$9.5K	$0

Sauk Prairie Healthcare Inc — 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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