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.

Iowa Physicians Clinic Medical Foundation (NPI 1366425274)

Key Findings

Field	Value
Entity Type	Organization
Organization	Iowa Physicians Clinic Medical Foundation
Address	1776 W Lakes Pkwy Ste 400
City	West Des Moines
State	IA
ZIP	50266
Taxonomy	General Practice Physician
NPI Enumerated	November 23, 2005

Payer Source	Total Paid
Medicaid	$102.7M
Medicare	$0

IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION reports $102.7M in lifetime Medicaid revenue and has no Medicare billing on file, making Medicaid the de facto single payer driving its public-program volume. The provider’s NPI was enumerated 2005-11-23 (~21 years ago), indicating a long-established presence in the state market.

Revenue is highly concentrated in a small set of outpatient E/M and vaccination codes: the precomputed top 3 codes by revenue account for 72.8% of this provider's total Medicaid revenue, led by 99213 ($39.5M revenue, 43.2%), 99214 ($21.8M revenue, 23.8%), and 90460 ($5.4M revenue, 5.9%). This concentration signals that routine office visits and pediatric immunizations are the primary revenue drivers for the practice.

The code mix (very large volumes of 99213 and 99214) identifies the operation as a high-volume general practice/primary care provider that handles a heavy caseload of established-patient outpatient visits. High counts for pediatric/preventive codes (99392, 99391, 99393) and vaccine codes (90460, 90461, 90686, 90471) further indicate integrated well-child and immunization services alongside adult primary care.

IOWA PHYSICIANS CLINIC is a dominant statewide provider for its core E/M and vaccination services: 99213 ranks #1 of 1312 providers in-state (100th percentile; extreme outlier) and 99214 ranks #1 of 1063 providers in-state (100th percentile; extreme outlier). These standings characterize the clinic as a market leader in volume for routine outpatient visits within Iowa.

Testing and infection-screening activity is also a major operational component: 87428 (SARS/influenza panel) has 15.4K claims and $1.9M revenue and ranks #1 in-state (100th percentile; extreme outlier), while 87880 (strep test) has 115.7K claims and $1.6M revenue and ranks #1 in-state (100th percentile; extreme outlier). Such volumes suggest the practice serves as a high-throughput site for respiratory and infectious-disease diagnostics.

Beyond ambulatory E/M, the provider bills significant inpatient and higher-acuity codes, indicating a broader service footprint that includes hospital-based care: 99232 (59.6K claims, $1.7M revenue) ranks #2 of 119 providers in-state (99th percentile; extreme outlier) and 99291 (6.9K claims, $617.8K revenue) ranks #2 of 28 providers in-state (96th percentile; notably above typical state volume). This mix implies capacity to support subsequent inpatient/observation care and some critical care encounters.

Preventive and developmental services are prominent in the profile: 99392 ($3.4M revenue) and 99391 ($3.1M revenue) both rank #1 in-state (100th percentile; extreme outlier), and 96110 (14.6K claims, $875.2K revenue) likewise ranks #1 in-state (100th percentile; extreme outlier). Coupled with high vaccine administration counts, these data point to a strong pediatric/preventive care orientation within the practice.

While many codes are extreme outliers in statewide volume, a few service lines appear unremarkable by comparison—for example, prenatal ultrasound 76811 (4.5K claims, $759K revenue) ranks #4 of 9 providers in-state (63th percentile; typical, unremarkable), psychotherapy 90834 (12.5K claims, $714.7K revenue) ranks #60 of 675 providers in-state (91th percentile; typical, unremarkable), and speech/hearing 92507 (9.9K claims, $613.4K revenue) ranks #13 of 59 providers in-state (79th percentile; typical, unremarkable). This indicates the practice’s standout strengths are concentrated in primary-care E/M, preventive pediatrics, immunizations, and high-throughput diagnostic testing rather than across every ambulatory sub-specialty.

Medicaid: Complete Services Breakdown

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

305 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…	1,160,700	$30	$39.5M
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…	483,350	$50	$21.8M
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.	119,630	$50	$5.4M
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…	46,120	$70	$3.4M
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…	45,850	$70	$3.1M
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	15,400	$120	$1.9M
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…	28,570	$60	$1.8M
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…	59,570	$30	$1.7M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	22,430	$70	$1.7M
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.	115,740	$10	$1.6M

Showing 1–10 of 305

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

Iowa Physicians Clinic Medical Foundation — 21 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

305 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	49	60	16,120	$150	$3.8M
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.	229	280	850	$140	$801.8K
J0585	Injection, onabotulinumtoxina, 1 unit	3	20	380	$700	$687.3K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	13	60	2,110	$70	$570.5K
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.	202	310	1,320	$100	$543.4K
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	5	10	2,020	$140	$527.6K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	4	10	3,460	$130	$479.9K
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…	60	680	670	$70	$343.5K
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…	9	40	900	$90	$249.3K
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…	2	120	1,100	$30	$162.6K

Showing 1–10 of 305

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Robert Young Center For Community Mental Health	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$12.8M
The Robert Young Center For Community Mental Health	IL	Substance Use Disorder Rehabilitation Clinic/Center	$0	$9.5M
The Robert Young Center For Community Mental Health	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$7.1M
The Iowa Clinic PC	IA	Family Medicine Physician	$0	$5.4M
St. Luke's Methodist Hospital	IA	Cardiovascular Disease Physician	$0	$3.9M
Chad Laurich	SD	Vascular Surgery Physician	$3.2M	$0
Allen Memorial Hospital Corporation	IA	Women's Health Nurse Practitioner	$0	$2.1M
Trinity Regional Medical Center	IA	Rural Health Clinic/Center	$0	$1.8M
Trinity Regional Medical Center	IA	Rural Health Clinic/Center	$0	$1.6M
Iowa Physicians Clinic Medical Foundation	IA	General Practice Physician	$0	$1.2M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Link Associates	IA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$83.3M
Iowa Family Services, Inc	IA	Community/Behavioral Health Agency	$0	$9.9M
Revell-warrington Dental PC	IA	Pediatric Dentistry	$0	$9.2M
Csa	IA	Community/Behavioral Health Agency	$0	$8.8M
Kyle Alliman	IA	Ophthalmology Physician	$8.7M	$0
City Of West Des Moines	IA	Land Ambulance	$726.2K	$5.1M
Austin Strohbehn	IA	Retina Specialist (Ophthalmology) Physician	$5.8M	$0
Wolfe Surgery Center, LLC	IA	Ambulatory Surgical Clinic/Center	$4.1M	$1.3M
Iowa Home Care, LLC	IA	Home Health Agency	$0	$5.4M
Divine Touch Of Iowa LLC	IA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$4.8M

Iowa Physicians Clinic Medical Foundation — 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