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.

Primary Health Care, Inc. (NPI 1316379845)

Field	Value
Entity Type	Organization
Organization	Primary Health Care, Inc.
Address	250 Laurel St
City	Des Moines
State	IA
ZIP	50314
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	August 7, 2013

Payer Source	Total Paid
Medicaid	$14.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

90 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	71,340	$200	$14.1M
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	1,070	$1	$1.1K
0513F	The provider documents a plan of care to manage elevated blood pressure in a patient with chronic kidney disease (CKD).	50	$20	$770
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…	40	$20	$700
3079F	No Summary found for this code	280	$1	$280
3075F	No Summary found for this code	110	$1	$110
3077F	No Summary found for this code	100	$1	$100
3044F	The A1C test (HbA1C test) is a blood test which shows the levels of glucose (sugar) in the blood. The provider uses the test to determine if the patient’s diabetes is well controlled. The provider…	10	$1	$40
2000F	No Summary found for this code	1,390	$0	$0
2001F	No Summary found for this code	2,480	$0	$0

Showing 1–10 of 90

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

Primary Health Care, Inc. — 1 of 8 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

90 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	14	330	3,960	$170	$2.8M
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…	475	680	670	$70	$343.5K
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…	52	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…	208	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…	66	1,310	760	$20	$153.1K
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…	609	610	550	$70	$145.9K
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…	18	170	540	$50	$101.2K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	158	400	110	$100	$101.1K
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…	21	190	300	$50	$91.7K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	22	80	250	$50	$87.1K

Showing 1–10 of 90

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Primary Health Care, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$15.6M
Primary Health Care, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$12.1M
Primary Health Care, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$11.5M
Primary Health Care, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$8M
Primary Health Care, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$7.9M
Primary Health Care, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$7.2M
Primary Health Care, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$5.3M
Primary Health Care, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$3.9M
Lazaro Rabang	IA	Internal Medicine Physician	$261.5K	$0
Duane Abbott	IA	Internal Medicine Physician	$50.3K	$0

Nearby Providers

Other providers in the same ZIP code as Primary Health Care, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Broadlawns Medical Center	IA	General Acute Care Hospital	$0	$112.9M
Catholic Health Initiatives-iowa Corp	IA	General Acute Care Hospital	$0	$26.4M
Des Moines Independent Community School District	IA	Local Education Agency (LEA)	$0	$22.8M
Broadlawns Medical Center	IA	Community/Behavioral Health Agency	$0	$13.2M
Mercy Clinics Inc	IA	Pediatric Adolescent Medicine Physician	$0	$10.7M
Des Moines River Physicians, LLC	IA	Emergency Medicine Physician	$0	$8.1M
Catholic Health Initiatives-iowa Corp	IA	Clinical Medical Laboratory	$0	$8M
Vita Health Services	IA	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$7.5M
House Of Mercy	IA	Substance Abuse Rehabilitation Facility	$0	$7.4M
Children And Families Of Iowa	IA	Substance Abuse Rehabilitation Facility	$0	$6.6M

Primary Health Care, Inc. — Billing Profile & Reimbursement Data

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Primary Health Care, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References