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.

Mason City Clinic PC (NPI 1043254055)

Mason City Clinic PC is a otolaryngology physician provider located in Mason City, Iowa. This profile covers 0 Medicare and 47 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	Mason City Clinic PC
Address	250 S Crescent Dr
City	Mason City
State	IA
ZIP	50401
Taxonomy	Otolaryngology Physician
NPI Enumerated	June 16, 2006

Payer Source	Total Paid
Medicaid	$1.1M
Medicare	$0

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

47 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	2,310	$100	$223.9K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	3,240	$70	$210.5K
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…	6,170	$20	$148.1K
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…	1,070	$60	$65.1K
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,…	3,840	$20	$61.5K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	1,090	$60	$60K
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…	1,610	$30	$50K
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…	460	$100	$46.3K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	590	$50	$29.1K
11721	The provider surgically debrides (debulks or removes) 6 or more abnormal, diseased, or infected nails.	1,680	$10	$23.5K

Showing 1–10 of 47

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

Mason City Clinic PC — 1 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

47 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	37	120	1,100	$30	$162.6K
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…	339	1,060	480	$40	$154.5K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	37	50	170	$410	$153.8K
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…	223	1,310	760	$20	$153.1K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	22	140	210	$120	$152.1K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	14	40	170	$90	$140.7K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	105	130	480	$30	$120.3K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	37	60	260	$210	$109.2K
95811	During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.	13	10	140	$240	$84.5K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	29	30	410	$120	$79.2K

Showing 1–10 of 47

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Amad Zineldine	AZ	Cardiovascular Disease Physician	$587K	$0
Kyle Ulveling	IA	Cardiovascular Disease Physician	$325.1K	$0
Rakshak Sarda	IA	Cardiovascular Disease Physician	$320.7K	$0
Eric Brandser	KY	Diagnostic Radiology Physician	$250.5K	$0
Susann Ravessoud	NM	Acute Care Nurse Practitioner	$210.8K	$0
Mudassir Malik	IA	Advanced Heart Failure and Transplant Cardiology Physician	$208.6K	$200
Denisa Hagau	IA	Cardiovascular Disease Physician	$202.7K	$0
Samuel Congello	IA	Interventional Cardiology Physician	$197.8K	$0
Ravinder Dervesh	IA	Interventional Cardiology Physician	$196.9K	$0
Michael Sarik	IA	Clinical Cardiac Electrophysiology Physician	$195.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Health Services-iowa Corp	IA	Rural Acute Care Hospital	$0	$45.7M
Prairie Ridge Integrated Behavioral Healthcare	IA	Substance Abuse Rehabilitation Facility	$0	$24.2M
North Iowa Vocational Center	IA	Developmentally Disabled Services Day Training Agency	$0	$15.3M
Mason City Community School District	IA	Local Education Agency (LEA)	$0	$6.8M
Community Health Center Of Fort Dodge, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$6.4M
City Of Mason City	IA	Land Ambulance	$616.5K	$4.3M
Todd Hoeppner	IA	Pediatric Dentistry	$0	$4.8M
North Iowa Mercy Clinics	IA	Emergency Medicine Physician	$0	$3.9M
North Iowa Transition Center	IA	Community/Behavioral Health Agency	$0	$3.7M
North Iowa Mercy Clinics	IA	Cardiovascular Disease Physician	$0	$2.7M

Mason City Clinic PC — Billing Profile & Reimbursement Data

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Mason City Clinic PC — 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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