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.

Ottumwa Health Group LLC (NPI 1386956290)

Ottumwa Health Group LLC is a gynecology physician provider located in Ottumwa, Iowa. This profile covers 0 Medicare and 66 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Ottumwa Health Group LLC
Address	1001 Pennsylvania Ave
City	Ottumwa
State	IA
ZIP	52501
Taxonomy	Gynecology Physician
NPI Enumerated	July 8, 2010

Payer Source	Total Paid
Medicaid	$2.2M
Medicare	$0

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

66 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…	36,920	$30	$1M
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…	6,150	$60	$375.1K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	4,040	$50	$185.8K
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…	3,600	$40	$140.4K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	1,070	$90	$93.2K
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…	1,860	$30	$55.8K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	2,040	$20	$40.7K
76801	In this procedure, the provider performs a real time or live image, ultrasound of a pregnant uterus for examination of the first or a single fetus and mother during the first trimester, or less than…	300	$100	$29.7K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	360	$70	$26.6K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	1,760	$10	$24.7K

Showing 1–10 of 66

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

Ottumwa Health Group LLC — 4 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

66 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	48	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…	227	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…	36	1,310	760	$20	$153.1K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	6	40	170	$90	$140.7K
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.	85	170	320	$20	$119.2K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	11	60	260	$210	$109.2K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	347	400	110	$100	$101.1K
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…	36	80	250	$50	$87.1K
90832	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…	158	280	530	$40	$80.1K
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.	228	250	240	$30	$72.7K

Showing 1–10 of 66

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ottumwa Health Group LLC	IA	Rural Health Clinic/Center	$0	$1.2M
Aneley Hundae	FL	Cardiovascular Disease Physician	$604.9K	$0
Jonathon Hennings	IA	Nurse Practitioner	$483.7K	$0
Melisa Coaker	IA	Sleep Medicine (Internal Medicine) Physician	$370.4K	$0
Mudassir Malik	IA	Advanced Heart Failure and Transplant Cardiology Physician	$208.6K	$200
Nathan Nicholson	IA	Orthopaedic Surgery Physician	$198.9K	$0
Michelle Schofield	AL	Psychiatry Physician	$17.9K	$123.6K
Aaron From	IA	Interventional Cardiology Physician	$129.6K	$0
Bradley Scott	IN	Family Medicine Physician	$117.2K	$0
Shawn Dawson	IA	Family Medicine Physician	$114K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
River Hills Community Health Center Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$77.5M
American Baptist Homes Of The Midwest	IA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$22.7M
Southern Iowa Mental Health Center	IA	Mental Health Clinic/Center (Including Community Mental Health Center)	$650	$17.5M
Tenco, Industries, Inc.	IA	Community/Behavioral Health Agency	$0	$13.5M
Rchp Ottumwa LLC	IA	General Acute Care Hospital	$0	$9.6M
Ottumwa Community School District	IA	Local Education Agency (LEA)	$0	$8.5M
Pella Regional Health Center	IA	Rural Health Clinic/Center	$0	$5.3M
Milestones Area Agency On Aging	IA	Home Delivered Meals	$0	$3.2M
Southern Iowa Economic Development Assoc	IA	Addiction (Substance Use Disorder) Counselor	$0	$2.6M
Mercy Medical Center-centerville	IA	Multi-Specialty Clinic/Center	$0	$2.6M

Ottumwa Health Group LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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