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.

Mercy Clinics Inc (NPI 1407036262)

Mercy Clinics Inc is a pediatric adolescent medicine physician provider located in Des Moines, Iowa. This profile covers 0 Medicare and 62 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	Mercy Clinics Inc
Address	330 Laurel St
City	Des Moines
State	IA
ZIP	50314
Taxonomy	Pediatric Adolescent Medicine Physician
NPI Enumerated	November 9, 2007

Payer Source	Total Paid
Medicaid	$10.7M
Medicare	$0

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

62 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…	80,370	$40	$3.1M
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…	19,520	$80	$1.5M
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…	16,790	$70	$1.1M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	12,380	$80	$941K
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…	13,500	$60	$783K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	6,060	$90	$521.2K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	22,680	$20	$499K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	35,270	$10	$458.5K
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.	8,600	$50	$404.1K
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…	2,570	$100	$259.1K

Showing 1–10 of 62

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

Mercy Clinics Inc — 15 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

62 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	61	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…	12	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.	107	170	320	$20	$119.2K
T1013	Sign language or oral interpretive services, per 15 minutes	19	30	300	$40	$112.3K
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…	2	170	540	$50	$101.2K
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…	2	190	300	$50	$91.7K
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.	14	250	240	$30	$72.7K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	60	180	220	$40	$56.6K
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…	6	80	240	$60	$51.1K
99204	The provider sees a new 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 provider…	142	250	110	$80	$47.1K

Showing 1–10 of 62

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Union Associated Physicians Clinic, LLC	IN	Family Medicine Physician	$0	$31.1M
Mercy Clinics Inc	IA	Primary Care Clinic/Center	$0	$3.7M
Mercy Clinics, Inc.	IA	Primary Care Clinic/Center	$0	$2.9M
Mercy Clinics, Inc.	IA	Primary Care Clinic/Center	$0	$2.8M
Catholic Health Initiatives-iowa Corp	IA	Clinical Cardiac Electrophysiology Physician	$0	$2.8M
Mercy Clinics, Inc.	IA	Primary Care Clinic/Center	$0	$2.8M
Mercy Clinics, Inc	IA	Hospitalist Physician	$0	$2.5M
Mercy Clinics, Inc	IA	Maternal & Fetal Medicine Physician	$0	$2.4M
Mercy Clinics, Inc.	IA	Endocrinology, Diabetes & Metabolism Physician	$0	$2.3M
Mercy Clinics, Inc.	IA	Primary Care Clinic/Center	$0	$2M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Broadlawns Medical Center	IA	General Acute Care Hospital	$0	$112.9M
Catholic Health Initiatives-iowa Corp	IA	General Acute Care Hospital	$0	$26.4M
Des Moines Independent Community School District	IA	Local Education Agency (LEA)	$0	$22.8M
Primary Health Care, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$14.1M
Broadlawns Medical Center	IA	Community/Behavioral Health Agency	$0	$13.2M
Des Moines River Physicians, LLC	IA	Emergency Medicine Physician	$0	$8.1M
Catholic Health Initiatives-iowa Corp	IA	Clinical Medical Laboratory	$0	$8M
Primary Health Care, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$7.9M
Vita Health Services	IA	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$7.5M
House Of Mercy	IA	Substance Abuse Rehabilitation Facility	$0	$7.4M

Mercy Clinics Inc — 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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