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.

Canistota School 43-1 (NPI 1912082132)

Field	Value
Entity Type	Organization
Organization	Canistota School 43-1
Address	715 E 14th St
City	Sioux Falls
State	SD
ZIP	57104
Taxonomy	Local Education Agency (LEA)
NPI Enumerated	October 26, 2006

Payer Source	Total Paid
Medicaid	$40.4K
Medicare	$0

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	960	$40	$40.3K
97139	Use 97139 to report therapeutic procedures that do not have a specific code.	10	$10	$100

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

Canistota School 43-1 — 0 of 2 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

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	33	60	1,050	$20	$108.2K
97139	Use 97139 to report therapeutic procedures that do not have a specific code.	27	30	430	$30	$45.1K

Nearby Providers

Other providers in the same ZIP code as Canistota School 43-1, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sanford Medical Center	SD	Clinical Medical Laboratory	$1.8M	$18M
Lutheran Social Services Of Sd	SD	Psychiatric Residential Treatment Facility	$0	$15.7M
Iwe Inc.	SD	In Home Supportive Care Agency	$0	$15M
City Of Sioux Falls	SD	Federally Qualified Health Center (FQHC)	$0	$8.6M
South Dakota Home Care, Inc.	SD	Respite Care	$0	$8.6M
Sanford Clinic	SD	Diagnostic Radiology Physician	$0	$6M
Paramedics Logistics South Dakota LLC	SD	Land Ambulance	$1.9M	$3.6M
Sanford Healthcare Accessories, LLC	SD	Durable Medical Equipment & Medical Supplies	$0	$3.1M
Behavior Care Specialists, Inc	SD	Behavior Analyst	$0	$2.9M
Asana Integrated Medical Group PC	SD	Psychiatry Physician	$0	$2.5M

Canistota School 43-1 — Billing Profile & Reimbursement Data

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Canistota School 43-1 — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References