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.

State University Of Iowa (NPI 1376544320)

Field	Value
Entity Type	Organization
Organization	State University Of Iowa
Address	200 Hawkins Dr
City	Iowa City
State	IA
ZIP	52242
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 2, 2005

Payer Source	Total Paid
Medicaid	$90.4M
Medicare	$0

Key Findings

STATE UNIVERSITY OF IOWA reports no Medicare billing on file and $90.4M in lifetime Medicaid revenue, so its billing footprint in these data is effectively single‑payer Medicaid. The absence of Medicare claims means analysts should treat observed activity as concentrated entirely within Medicaid payment streams for this dataset.

Revenue is highly concentrated: the provider’s top three Medicaid codes (G0463, 99285, 99283) account for 80.1% of its total Medicaid revenue, with G0463 alone representing $55.1M (70.7% of Medicaid revenue). This concentration indicates that a single outpatient clinic visit code is the dominant source of Medicaid dollars for the organization.

The code mix signals a combined outpatient clinic and emergency‑care orientation. G0463 (hospital outpatient clinic visit) dominance, together with sizable Medicaid revenue from ED evaluation-and-management codes 99285 ($4.8M, 6.1%) and 99283 ($2.6M, 3.3%), indicates operations that rely on high-volume outpatient clinic encounters plus substantial emergency department throughput.

STATE UNIVERSITY OF IOWA is a statewide outlier on outpatient clinic volume: G0463 ranks #1 of 70 providers in-state and is labeled an extreme outlier (100th percentile). This establishes the provider as the dominant in-state source of Medicaid revenue for hospital outpatient clinic visit services.

Emergency department activity shows mixed competitive standing: 99285 ranks #47 of 179 (74th percentile), a typical statewide position for high-acuity ED visits, while 99283 ranks #26 of 305 (92th percentile), indicating comparatively strong volume for lower‑acuity ED visits. Together these ranks imply the hospital runs a busy ED with above‑peer volumes especially for lower‑acuity evaluations.

Several other services are notable state outliers or top-ranked items: 90471 (vaccination) is labeled an extreme outlier at the 99th percentile with 25.7K claims, 87635 (SARS–CoV–2 NAAT) ranks #1 of 166 (100th percentile, extreme outlier) with 16.3K claims, and 96365 (initial IV infusion) ranks #1 of 38 (100th percentile, extreme outlier). These patterns point to unusually large Medicaid volumes in immunization, COVID testing, and infusion administration relative to state peers.

Diagnostic and specialty procedure volume is material but less dominant: 70553 (brain MRI) generated $1.6M and ranks #2 of 16 (93th percentile), while cardiac imaging codes such as 93306 ($1.0M) and 93303 ($710.6K) show meaningful echocardiography activity. Obstetric/fetal imaging (76811, $794.1K, rank #3 of 9) and other specialty services appear as important ancillary revenue streams supporting the provider’s outpatient and hospital-based clinical platform.

The provider’s NPI was enumerated on 2005-08-02 (~21 years ago), indicating long tenure in the market; combined with the concentration and multiple code-level statewide leadership positions, the entity constitutes an established Medicaid-focused hospital presence whose negotiation, network, and capacity assessments should be centered on outpatient clinic and ED service volumes.

Medicaid: Complete Services Breakdown

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

455 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	598,680	$90	$55.1M
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.	3,520	$1,360	$4.8M
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.	19,610	$130	$2.6M
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	4,330	$360	$1.6M
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.	7,270	$190	$1.3M
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	25,690	$50	$1.2M
J3380	Injection, vedolizumab, intravenous, 1 mg	610	$1,910	$1.2M
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…	2,760	$370	$1M
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…	4,590	$170	$794.1K
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…	16,340	$50	$784.2K

Showing 1–10 of 455

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

State University Of Iowa — 7 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

455 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	1	70	1,440	$90	$2.8M
J0178	Injection, aflibercept, 1 mg	3	10	30	$710	$1.4M
J3380	Injection, vedolizumab, intravenous, 1 mg	1	10	610	$1,910	$1.2M
96159	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of a patient’s physical health…	64	70	3,810	$130	$1.1M
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.	52	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.	47	180	340	$170	$722K
J0585	Injection, onabotulinumtoxina, 1 unit	11	20	380	$700	$687.3K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	1	10	530	$1,200	$630.1K
G0176	Activity therapy, such as music, dance, art or play therapies not for recreation, related to the care and treatment of patient's disabling mental health problems, per session (45 minutes or more)	2	10	3,860	$160	$622.5K
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…	43	60	2,110	$70	$570.5K

Showing 1–10 of 455

Related Providers

Other providers that share a Tax Identification Number (TIN) with State University Of Iowa, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
State University Of Iowa	IA	Family Medicine Physician	$0	$103.8M
State University Of Iowa	IA	Dentist	$0	$25.8M
Thomas Buroker	IA	Medical Oncology Physician	$9.4M	$0
State University Of Iowa	IA	Dentist	$0	$5.6M
Robert Behrens	IA	Medical Oncology Physician	$5.2M	$0
State University Of Iowa	IA	Psychologist	$0	$4.6M
Mission Cancer And Blood, PLLC	IA	Hematology & Oncology Physician	$0	$2.8M
Mercy Services Iowa City, Inc.	IA	Multi-Specialty Clinic/Center	$0	$2.4M
Bradley Hiatt	IA	Medical Oncology Physician	$2.2M	$0
State University Of Iowa	IA	Clinical Medical Laboratory	$1.5K	$1.9M

Nearby Providers

Other providers in the same ZIP code as State University Of Iowa, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Annalee Fencl	IA	Student in an Organized Health Care Education/Training Program	$0	$2.5M
Brandon Syme	IA	General Practice Dentistry	$0	$1.3M
Lorna Grant	IA	Ophthalmology Physician	$1.2M	$0
State University Of Iowa	IA	Clinical Medical Laboratory	$163K	$338.8K
Tyler Risma	IA	Ophthalmology Physician	$423.2K	$0
Jessica Parkhurst	IA	Radiation Oncology Physician	$395.3K	$0
Amith George Jacob	IA	Critical Care Medicine (Internal Medicine) Physician	$178.2K	$216.1K
Leslie Christenson	IA	MOHS-Micrographic Surgery Physician	$354.2K	$0
Oluwaseun Adeola	IA	Clinical Cardiac Electrophysiology Physician	$345K	$0
Andrew Pugely	IA	Orthopaedic Surgery of the Spine Physician	$327.4K	$0

State University Of Iowa — 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