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.

Ellsworth Municipal Hospital (NPI 1043229735)

Ellsworth Municipal Hospital is a family medicine physician provider located in Iowa Falls, Iowa. This profile covers 0 Medicare and 24 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	Ellsworth Municipal Hospital
Address	920 South Oak St
City	Iowa Falls
State	IA
ZIP	50126
Taxonomy	Family Medicine Physician
NPI Enumerated	August 5, 2006

Payer Source	Total Paid
Medicaid	$1.2M
Medicare	$0

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

24 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	12,510	$50	$613K
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…	12,500	$40	$449.9K
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…	220	$90	$20.8K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	1,810	$10	$18.1K
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,…	520	$30	$14.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	130	$90	$10.9K
87561	The lab analyst performs a test for Mycobacterium avium intracellulare, MAI, using amplified nucleic acid probe technique. Mycobacteria are bacteria, sometimes called acid fast bacteria because of…	460	$20	$10.1K
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…	180	$50	$8.3K
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…	680	$10	$8.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	110	$80	$8.1K

Showing 1–10 of 24

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

Ellsworth Municipal Hospital — 0 of 23 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

24 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…	67	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…	133	1,310	760	$20	$153.1K
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…	158	190	300	$50	$91.7K
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…	51	130	120	$80	$52.1K
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…	93	100	130	$40	$44.7K
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…	80	170	170	$40	$40.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	124	250	110	$50	$39.9K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	147	300	250	$10	$19.6K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	396	460	820	$1	$19K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	130	290	100	$40	$17.2K

Showing 1–10 of 24

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ellsworth Municipal Hospital	IA	Critical Access Hospital	$0	$3.8M
Aaron Heiar	IA	Family Medicine Physician	$200.8K	$0
Jagmeet Singh	PA	Nephrology Physician	$152.3K	$800
Mindy Gingery	IA	Psychiatric/Mental Health Nurse Practitioner	$25.1K	$0
Shannan Larson	IA	Certified Registered Nurse Anesthetist	$23.8K	$0
Dominic Formaro	IA	Surgery Physician	$20.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
City Of Iowa Falls	IA	Land Ambulance	$253K	$355.5K
Andrea Bartling	IA	Physician Assistant	$75.4K	$0
Brian Vold	IA	Psychiatric/Mental Health Nurse Practitioner	$32.5K	$11.3K

Ellsworth Municipal Hospital — Billing Profile & Reimbursement Data

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Ellsworth Municipal Hospital — 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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