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

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

Boone County Family Medicine Tr (NPI 1033154836)

Boone County Family Medicine Tr is a family medicine physician provider located in Boone, Iowa. This profile covers 0 Medicare and 32 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	Boone County Family Medicine Tr
Address	1115 S Marshall St
City	Boone
State	IA
ZIP	50036
Taxonomy	Family Medicine Physician
NPI Enumerated	June 17, 2006

Payer Source	Total Paid
Medicaid	$858.1K
Medicare	$0

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

32 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…	11,750	$30	$399.5K
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…	7,570	$50	$355.9K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	2,970	$10	$26.7K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	5,640	$1	$16.9K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	1,290	$10	$11.6K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	100	$90	$8.9K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	320	$20	$6.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	70	$80	$5.4K
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,…	210	$30	$5.3K
99391	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…	60	$60	$3.7K

Showing 1–10 of 32

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Iowa Distribution

Boone County Family Medicine Tr — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Iowa

Full comparison — all codes billed, vs. Iowa median

32 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…	121	1,060	480	$40	$154.5K
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…	143	1,310	760	$20	$153.1K
99391	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…	137	170	540	$50	$101.2K
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…	157	190	300	$50	$91.7K
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	30	40	370	$40	$61K
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.	171	180	1,660	$10	$58.8K
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.	136	180	220	$40	$56.6K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	180	180	230	$10	$44.9K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	36	100	130	$40	$44.7K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	217	240	1,930	$10	$40.5K

Showing 1–10 of 32

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Boone County Hospital	IA	Family Medicine Physician	$0	$1.2M
Boone County Hospital	IA	Critical Access Hospital	$0	$1.1M
Travis Mattson	IA	Emergency Medicine Physician	$85.9K	$0
Michael Nguyen	SD	Sports Medicine (Family Medicine) Physician	$24.3K	$0
Dianne Cooper	IA	Certified Registered Nurse Anesthetist	$1.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Boone C.s.d.	IA	Local Education Agency (LEA)	$0	$4.2M
Hy-vee Inc	IA	Community/Retail Pharmacy	$156K	$75K
Kinne Family Pharmacy Inc	IA	Community/Retail Pharmacy	$72.4K	$3K

Boone County Family Medicine Tr — Billing Profile & Reimbursement Data

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Boone County Family Medicine Tr — 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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