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.

Montgomery County Memorial Hospital (NPI 1376539338)

Field	Value
Entity Type	Organization
Organization	Montgomery County Memorial Hospital
Address	2301 Eastern Ave
City	Red Oak
State	IA
ZIP	51566
Taxonomy	Critical Access Hospital
NPI Enumerated	September 26, 2005

Payer Source	Total Paid
Medicaid	$1.7M
Medicare	$0

Medicaid: Complete Services Breakdown

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

52 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	4,930	$130	$636.4K
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.	1,370	$220	$295.1K
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.	4,570	$50	$205.8K
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.	500	$360	$181.1K
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…	4,590	$20	$110.1K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	5,940	$10	$41.6K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	620	$50	$33.4K
0241U	N/A	110	$210	$23.7K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	220	$60	$12.6K
0240U	N/A	60	$190	$12.2K

Showing 1–10 of 52

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

Montgomery County Memorial Hospital — 0 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

52 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	69	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.	115	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.	78	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.	78	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.	56	90	320	$120	$327.7K
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…	897	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…	986	1,310	760	$20	$153.1K
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.	137	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.	42	70	180	$60	$101.5K
0241U	N/A	52	80	290	$110	$85.1K

Showing 1–10 of 52

Related Providers

Other providers that share a Tax Identification Number (TIN) with Montgomery County Memorial Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Physicians Clinic Inc	NE	Family Medicine Physician	$0	$20.5M
Matthew Appenzeller	NE	Ophthalmology Physician	$2.5M	$0
Mark Emig	NE	Ophthalmology Physician	$2.2M	$0
Montgomery County Memorial Hospital	IA	Rural Health Clinic/Center	$0	$1.9M
Sakeer Hussain	IA	Hematology & Oncology Physician	$1.9M	$0
David Ingvoldstad	NE	Ophthalmology Physician	$1.8M	$0
Bliss O'bryhim	MO	Retina Specialist (Ophthalmology) Physician	$1.5M	$0
Montgomery County Memorial Hospital	IA	Rural Health Clinic/Center	$0	$1M
Edward Taylor	NE	Internal Medicine Physician	$658.9K	$0
Thomas Franco	NE	Physical Medicine & Rehabilitation Physician	$526.6K	$0

Nearby Providers

Other providers in the same ZIP code as Montgomery County Memorial Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
City Of Red Oak	IA	Land Ambulance	$202.2K	$102.1K
Warren Hayes	IA	Family Medicine Physician	$55.4K	$0
Sharon Johnson	IA	Obstetrics & Gynecology Nurse Practitioner	$22.4K	$0
Daniela Donoso Pena	IA	Internal Medicine Physician	$1.1K	$0

Montgomery County Memorial Hospital — Billing Profile & Reimbursement Data

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Montgomery County Memorial Hospital — 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