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.

Sanford Health Network (NPI 1871517318)

Field	Value
Entity Type	Organization
Organization	Sanford Health Network
Address	300 S Byron Blvd
City	Chamberlain
State	SD
ZIP	57325
Taxonomy	Family Medicine Physician
NPI Enumerated	July 27, 2006

Payer Source	Total Paid
Medicaid	$142.7K
Medicare	$0

Medicaid: Complete Services Breakdown

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

11 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…	1,720	$40	$67.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	340	$70	$24.3K
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…	660	$30	$18.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	230	$60	$14.2K
17110	The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or…	110	$90	$9.8K
99383	The provider performs a well–patient visit for a child who is between the ages of 5 and 11 who meets the definition of new patient.	70	$80	$5.1K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	260	$10	$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,…	40	$30	$1.4K
99384	The provider performs a well–patient visit for an adolescent who is between the ages of 12 and 17 who meets the definition of new patient.	10	$10	$170
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	10	$10	$120

Showing 1–10 of 11

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

Sanford Health Network — 0 of 11 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

11 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…	138	340	1,010	$100	$511K
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,…	126	160	210	$120	$97.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	20	60	170	$90	$66.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	151	160	180	$40	$59.6K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	22	70	110	$110	$42.9K
99383	The provider performs a well–patient visit for a child who is between the ages of 5 and 11 who meets the definition of new patient.	5	10	160	$130	$30.7K
17110	The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or…	9	10	180	$60	$29K
99384	The provider performs a well–patient visit for an adolescent who is between the ages of 12 and 17 who meets the definition of new patient.	5	10	30	$180	$26.3K
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…	15	60	190	$30	$20.1K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	28	50	310	$10	$14.3K

Showing 1–10 of 11

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sanford Medical Center	SD	Family Medicine Physician	$0	$68.8M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Sanford Medical Center	SD	General Acute Care Hospital	$0	$24.4M
Sanford Health Network	MN	Rural Acute Care Hospital	$0	$7.6M
Sanford Health Network	IA	Family Medicine Physician	$0	$6.6M
Sanford Clinic	SD	Diagnostic Radiology Physician	$0	$6M
Sanford Clinic	SD	Pediatrics Physician	$0	$5.5M
Sanford Health Network	SD	General Acute Care Hospital	$0	$4.4M
Sanford Clinic	SD	Hospitalist Physician	$0	$2.9M

Nearby Providers

Other providers in the same ZIP code as Sanford Health Network, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dakota Milestones	SD	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$18.6M
Dakota Milestones	SD	Case Manager/Care Coordinator	$0	$1.7M
Sanford Health Network	SD	Critical Access Hospital	$0	$1.5M
605 Vision, PC	SD	Optometrist	$0	$1.3M
Sanford Health Network	SD	Critical Access Hospital	$0	$1M
Dakota Milestones	SD	Case Manager/Care Coordinator	$0	$284.5K
Dakota Milestones	SD	Case Manager/Care Coordinator	$0	$268.7K
Rural Health Care, Inc.	SD	Federally Qualified Health Center (FQHC)	$0	$233.9K
Missouri Valley Ambulance Service	SD	Land Ambulance	$75.5K	$95.8K
Chamberlain Family Dentistry	SD	Dental Clinic/Center	$0	$110.5K

Sanford Health Network — Billing Profile & Reimbursement Data

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Sanford Health Network — 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