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.

Shenandoah Medical Center (NPI 1184621096)

Shenandoah Medical Center is a critical access hospital provider located in Shenandoah, Iowa. This profile covers 0 Medicare and 81 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	Shenandoah Medical Center
Address	300 Pershing Ave
City	Shenandoah
State	IA
ZIP	51601
Taxonomy	Critical Access Hospital
NPI Enumerated	July 7, 2005

Payer Source	Total Paid
Medicaid	$2.4M
Medicare	$0

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

81 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	5,010	$120	$621K
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…	10,100	$30	$282.7K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	16,320	$20	$244.8K
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.	5,630	$40	$214K
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…	2,220	$60	$139.6K
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.	2,740	$40	$120.7K
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…	1,880	$50	$86.6K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	720	$110	$79.4K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	1,440	$30	$43.3K
87081	The lab analyst cultures a patient specimen on a test medium designed to grow only a specific pathogenic organism.	1,640	$20	$39.4K

Showing 1–10 of 81

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

Shenandoah Medical Center — 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

81 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5170	Home delivered meals, including preparation; per meal	47	60	1,150	$20	$14M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	37	70	1,440	$90	$2.8M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	59	280	850	$140	$801.8K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	119	180	340	$170	$722K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	186	310	1,320	$100	$543.4K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	34	90	320	$120	$327.7K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	39	40	900	$90	$249.3K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	87	90	740	$60	$155.6K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	53	170	320	$20	$119.2K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	25	70	180	$60	$101.5K

Showing 1–10 of 81

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shenandoah Medical Center	IA	Rural Health Clinic/Center	$0	$9.4M
Sakeer Hussain	IA	Hematology & Oncology Physician	$1.9M	$0
Shyam Akkulugari	KS	Family Medicine Physician	$399.3K	$2.9K
Erik Otterberg	NE	Orthopaedic Surgery Physician	$204.2K	$0
Darren Keiser	NE	Orthopaedic Surgery Physician	$149.4K	$0
James Mantone	IA	Orthopaedic Surgery Physician	$107.5K	$0
Jeremy Pepin	IA	Nephrology Physician	$103.4K	$0
Mohamed Abdi	IA	Radiation Oncology Physician	$68.3K	$0
Michael Del Core	NE	Orthopaedic Hand Surgery Physician	$64K	$0
Kathleen Grier	NE	Orthopaedic Surgery Physician	$56.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nishna Productions, Inc.	IA	Community/Behavioral Health Agency	$0	$63.5M
Midwest Mental Health LLC	IA	Mental Health Counselor	$0	$4.8M
Shenandoah Ambulance Service	IA	Land Ambulance	$230.3K	$147.6K
Michael Morrison	IA	Orthopaedic Surgery Physician	$47.5K	$0
Michael Woods	IA	Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician	$6.6K	$0

Shenandoah Medical Center — 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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