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

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

Welia Health (NPI 1992012207)

Welia Health is a rural health clinic/center provider located in Pine City, Minnesota. This profile covers 0 Medicare and 41 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	Welia Health
Address	1425 Main Street North
City	Pine City
State	MN
ZIP	55063
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	September 8, 2010

Payer Source	Total Paid
Medicaid	$6.2M
Medicare	$0

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

41 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…	37,020	$120	$4.3M
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…	11,070	$120	$1.3M
X5622	N/A	1,110	$190	$210.2K
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,…	1,820	$110	$205.9K
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…	1,170	$120	$144.5K
99203	The provider sees a new 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 provider…	640	$100	$61.9K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	2,880	$1	$5.8K
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…	30	$130	$3.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	130	$30	$3.4K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	10	$210	$2.5K

Showing 1–10 of 41

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Minnesota Distribution

Welia Health — 1 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. Minnesota median

41 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	187	1,180	1,150	$80	$605.7K
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…	60	1,200	1,030	$70	$549.7K
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…	93	420	230	$90	$186.2K
S0302	Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)	125	310	810	$30	$166.5K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	204	240	610	$70	$165.5K
X5622	N/A	110	300	470	$60	$159.8K
99204	The provider sees a new 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 provider…	298	350	150	$90	$110.6K
99203	The provider sees a new 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 provider…	134	450	140	$60	$101.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	200	250	250	$70	$98.6K
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…	99	140	60	$120	$90.7K

Showing 1–10 of 41

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Allina Health System	MN	Ambulance	$9M	$118M
Allina Health System	MN	General Acute Care Hospital	$0	$48.8M
Allina Health System	MN	Internal Medicine Physician	$0	$32.9M
Allina Health System	MN	General Acute Care Hospital	$0	$27M
Allina Health System	MN	General Acute Care Hospital	$0	$25.7M
Allina Health System	MN	Family Medicine Physician	$0	$22.2M
Allina Health System	MN	Physical Medicine & Rehabilitation Physician	$0	$18.2M
Welia Health	MN	Critical Access Hospital	$0	$14.4M
Allina Health System	MN	Obstetrics & Gynecology Physician	$0	$13.2M
St Francis Regional Medical Center	MN	General Acute Care Hospital	$0	$13M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Therapeutic Services Agency Inc	MN	Marriage & Family Therapist	$0	$15.6M
Meadow Creek LLC	MN	Substance Abuse Rehabilitation Facility	$0	$15.4M
Walmart Inc.	MN	Community/Retail Pharmacy	$106K	$60

Welia Health — Billing Profile & Reimbursement Data

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Welia Health — 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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