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.

Lakes Regional Healthcare (NPI 1306100615)

Lakes Regional Healthcare is a family medicine physician provider located in Spirit Lake, Iowa. This profile covers 0 Medicare and 33 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	Lakes Regional Healthcare
Address	2700 23rd St Ste C
City	Spirit Lake
State	IA
ZIP	51360
Taxonomy	Family Medicine Physician
NPI Enumerated	July 2, 2012

Payer Source	Total Paid
Medicaid	$1.3M
Medicare	$0

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

33 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…	25,820	$30	$826.2K
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…	9,600	$40	$393.6K
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…	540	$60	$34.7K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	1,950	$10	$19.5K
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…	250	$70	$17.8K
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	1,430	$10	$15.7K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	580	$10	$8.1K
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…	830	$10	$7.4K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	1,770	$1	$5.3K
90734	The provider administers a meningococcal conjugate vaccine in a diphtheria toxoid carrier (MenACWY–D) or CRM197 carrier (MenACWY–CRM) to protect the patient from four strains of meningococcal viruses…	150	$30	$4.1K

Showing 1–10 of 33

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

Lakes Regional Healthcare — 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

33 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…	97	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…	61	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…	83	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…	102	190	300	$50	$91.7K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	240	250	240	$30	$72.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	161	250	110	$50	$39.9K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	39	70	120	$30	$22.3K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	104	120	180	$30	$21.4K
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.	232	300	250	$10	$19.6K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	183	460	820	$1	$19K

Showing 1–10 of 33

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lakes Regional Healthcare	IA	General Acute Care Hospital	$0	$1M
Jason Hough	IA	Orthopaedic Surgery Physician	$297.8K	$0
Jenny Nelson	SD	MOHS-Micrographic Surgery Physician	$285.1K	$0
Todd Zimprich	SD	Neurology Physician	$196.6K	$0
Kurt Rosenkrans	IA	Family Medicine Physician	$182.4K	$0
Christopher Rierson	IA	Orthopaedic Surgery Physician	$165.4K	$0
Mark Milleman	IA	Urology Physician	$143.4K	$0
Brett Olson	IA	Family Medicine Physician	$139.6K	$0
Andrew Pick	IA	Orthopaedic Surgery Physician	$128.4K	$0
Michael Hibbard	SD	Cardiovascular Disease Physician	$101.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lakes Lifeskills LLC	IA	Community/Behavioral Health Agency	$0	$31.5M
Crystal Meyer	IA	Nurse Practitioner	$257.6K	$0
Randy Cornwall	IA	Optometrist	$144.1K	$97.9K
Courtney Bolluyt	IA	Physician Assistant	$234.7K	$0
Walmart Inc.	IA	Community/Retail Pharmacy	$133.6K	$0
Nicole Stall	IA	Family Nurse Practitioner	$46.1K	$0
Laith Mahdi	IA	Emergency Medicine Physician	$38.3K	$0
John Sherrill	IA	Certified Registered Nurse Anesthetist	$22.3K	$0
Sarah Berte-greinert	IA	Clinical Social Worker	$5.8K	$0

Lakes Regional Healthcare — Billing Profile & Reimbursement Data

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Lakes Regional Healthcare — 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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