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 Specialty Hospital- Clarion (NPI 1386671246)

Field	Value
Entity Type	Organization
Organization	Iowa Specialty Hospital- Clarion
Address	1316 S Main St
City	Clarion
State	IA
ZIP	50525
Taxonomy	Critical Access Hospital
NPI Enumerated	June 27, 2006

Payer Source	Total Paid
Medicaid	$1.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

56 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	950	$310	$298K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	7,350	$30	$198.6K
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.	4,240	$50	$194.9K
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.	1,080	$100	$110.2K
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.	700	$140	$95.1K
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.	1,180	$70	$82.7K
99281	The provider sees a patient for the lowest level emergency department visit.	710	$100	$72.6K
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…	2,040	$30	$65.3K
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.	660	$70	$47.4K
73721	In this diagnostic procedure, the provider performs magnetic resonance imaging of a lower extremity joint without using contrast material.	50	$760	$36.4K

Showing 1–10 of 56

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 Specialty Hospital- Clarion — 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

56 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	61	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.	143	280	850	$140	$801.8K
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.	164	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.	80	90	320	$120	$327.7K
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.	38	170	320	$20	$119.2K
0241U	N/A	69	80	290	$110	$85.1K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	31	60	320	$30	$72.6K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	31	60	300	$30	$71.8K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	48	60	120	$50	$71.4K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	12	20	100	$60	$71K

Showing 1–10 of 56

Nearby Providers

Other providers in the same ZIP code as Iowa Specialty Hospital- Clarion, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Iowa Specialty Hospital- Clarion	IA	Rural Health Clinic/Center	$0	$6.9M
White Drug Enterprises Inc	IA	Community/Retail Pharmacy	$51.6K	$640
Angela Frietze	IA	Certified Registered Nurse Anesthetist	$39.8K	$0
Richard Bose	IA	Specialist	$26.7K	$0
Ericha Worple	IA	Surgery Physician	$19.6K	$0
Brandon Taylor	IA	Certified Registered Nurse Anesthetist	$12.2K	$0
Jacob Boll	IA	Certified Registered Nurse Anesthetist	$7.2K	$0
Carla Aldrich	IA	Certified Registered Nurse Anesthetist	$5.6K	$0
Beth Brady	IA	Anesthesiology Physician	$3.1K	$0

Iowa Specialty Hospital- Clarion — Billing Profile & Reimbursement Data

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Iowa Specialty Hospital- Clarion — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References