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.

Peoples Community Health Clinic, Inc. (NPI 1093703639)

Field	Value
Entity Type	Organization
Organization	Peoples Community Health Clinic, Inc.
Address	905 Franklin St
City	Waterloo
State	IA
ZIP	50703
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	October 7, 2005

Payer Source	Total Paid
Medicaid	$44.8M
Medicare	$0

Key Findings

PEOPLES COMMUNITY HEALTH CLINIC, INC. is effectively a single-payer Medicaid provider: total Medicaid revenue on file is $44.8M and there is no Medicare billing on file. This profile indicates the organization’s financial footprint is overwhelmingly driven by Medicaid rather than a mixed Medicare/Medicaid payer mix.

Revenue is highly concentrated in a very small set of codes: the precomputed top 3 Medicaid codes account for 98.8% of the provider’s total Medicaid revenue. The single largest code, T1015, generates $35.3M revenue (78.7% of this provider's total Medicaid revenue), followed by D9999 with $5.9M (13.3%) and D0999 with $3.1M (6.8%).

The provider’s taxonomy as a Federally Qualified Health Center (FQHC) aligns with its dominant use of an all-inclusive clinic visit code: T1015 (Clinic visit/encounter, all-inclusive) has 177.2K claims at $199 avg paid/claim and produces $35.3M in revenue. FQHC-specific visit billing is also present via G0467 (4.5K claims, $31 avg paid/claim, $140.2K revenue), but T1015 is the operational center of gravity, implying a high-volume, bundled primary care delivery model typical of community health centers.

Dental and preventive oral-care activity is a meaningful secondary service line: multiple dental codes show elevated volumes and high in-state percentiles (for example, D0120 with 10.7K claims and $32.2K revenue at the 97th percentile, D1206 with 16K claims and $31.9K revenue at the 98th percentile, and D1110 with 9.3K claims and $18.6K revenue at the 98th percentile). These figures indicate a substantial dental care program co-located with primary care, with many dental codes ranked notably above typical state volumes or identified as extreme outliers.

Competitive standing is uneven across codes: for the dominant T1015 code the clinic ranks #4 of 327 providers in-state (99th percentile; extreme outlier), identifying it as a major statewide provider for bundled clinic visits. By contrast, its other top revenue codes D9999 (rank #8 of 41, 83th percentile) and D0999 (rank #9 of 31, 73th percentile) are described as typical or unremarkable in-state volumes, meaning its dominance is concentrated in the T1015 line rather than broadly across multiple large-volume codes.

FQHC-related care coordination and quality measures appear but are small revenue contributors: S0280 (Medical home program, initial plan) shows 3.4K claims and $151.3K revenue, and quality/lab-related codes such as 3044F (668 claims, $1.3K revenue) and 3048F (539 claims, $539 revenue) are present at modest levels. These smaller lines are consistent with a community health center that bills for a mix of care coordination and performance measurement in addition to high-volume clinic visits.

The provider demonstrates long tenure in the market: the NPI was enumerated on 2005-10-07 (~21 years ago), indicating an established presence as an FQHC in Waterloo, IA. This longevity, paired with concentrated Medicaid revenue, suggests organizational stability within the Medicaid network and likely entrenched relationships with Medicaid-managed care plans.

For payers and contracting teams, the clinic’s financial sensitivity to Medicaid clinic-visit policy is material: $35.3M of revenue is tied to T1015 (78.7% of the provider’s total Medicaid revenue), so adjustments to reimbursement or authorization requirements for clinic visits could have outsized impact. Likewise, the sizable dental service volumes (multiple dental codes at high percentiles) create additional leverage and service-line considerations during network negotiations and program design.

Medicaid: Complete Services Breakdown

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

182 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	177,230	$200	$35.3M
D9999	N/A	30,790	$190	$5.9M
D0999	N/A	13,440	$230	$3.1M
S0280	Medical home program, comprehensive care coordination and planning, initial plan	3,360	$50	$151.3K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	4,520	$30	$140.2K
D0120	Periodic oral evaluation - established patient	10,720	$1	$32.2K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	15,950	$1	$31.9K
D1120	Prophylaxis–child	8,290	$1	$24.9K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	9,300	$1	$18.6K
D0274	N/A	8,860	$1	$17.7K

Showing 1–10 of 182

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

Peoples Community Health Clinic, Inc. — 11 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

182 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	4	330	3,960	$170	$2.8M
D9999	N/A	8	40	6,850	$180	$2.7M
D0999	N/A	9	30	6,470	$210	$1.8M
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	249	680	670	$70	$343.5K
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…	23	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…	11	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…	6	140	210	$120	$152.1K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	104	610	550	$70	$145.9K
S0280	Medical home program, comprehensive care coordination and planning, initial plan	5	20	820	$40	$138.9K
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…	16	170	540	$50	$101.2K

Showing 1–10 of 182

Related Providers

Other providers that share a Tax Identification Number (TIN) with Peoples Community Health Clinic, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sami Sibai	IL	Diagnostic Radiology Physician	$184.8K	$846.8K
Karen Sadler	IA	Nurse Practitioner	$158.2K	$0
Kirby Clark	IA	Diagnostic Radiology Physician	$132.5K	$21.7K

Nearby Providers

Other providers in the same ZIP code as Peoples Community Health Clinic, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Allen Memorial Hospital Corporation	IA	General Acute Care Hospital	$0	$21.9M
Exceptional Persons Inc	IA	Mental Illness Community Based Residential Treatment Facility	$0	$17.2M
City Of Waterloo	IA	Land Ambulance	$525.8K	$15.3M
Allen Memorial Hospital Corporation	IA	Emergency Medicine Physician	$0	$6.9M
Bakari Behavioral Health Inc.	IA	Community/Behavioral Health Agency	$0	$6.1M
Iowa Northland Regional Transit Commission	IA	Bus	$0	$2.8M
North Iowa Juvenile Detention Services	IA	Mental Illness Community Based Residential Treatment Facility	$0	$2.3M
Allen Memorial Hospital Corporation	IA	Women's Health Nurse Practitioner	$0	$2.1M
Open Arms Home Health Care - Waterloo, LLC	IA	Home Health Agency	$0	$1M
Joud Dib	IA	Cardiovascular Disease Physician	$366.7K	$0

Peoples Community Health Clinic, Inc. — Billing Profile & Reimbursement Data

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Peoples Community Health Clinic, Inc. — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References