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.

Shenandoah Medical Center (NPI 1427300201)

Shenandoah Medical Center is a rural health clinic/center provider located in Shenandoah, Iowa. This profile covers 0 Medicare and 36 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	Shenandoah Medical Center
Address	1 Jack Foster Dr
City	Shenandoah
State	IA
ZIP	51601
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	October 4, 2012

Payer Source	Total Paid
Medicaid	$9.4M
Medicare	$0

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

36 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	69,000	$130	$9.1M
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…	30,480	$10	$182.9K
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…	27,930	$1	$83.8K
S0280	Medical home program, comprehensive care coordination and planning, initial plan	740	$40	$25.8K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	510	$20	$10.1K
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…	100	$20	$2.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	310	$1	$920
G0511	Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral…	40	$20	$880
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…	670	$1	$670
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…	330	$1	$670

Showing 1–10 of 36

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

Shenandoah Medical Center — 3 of 16 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

36 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	15	330	3,960	$170	$2.8M
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…	24	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…	56	1,310	760	$20	$153.1K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	116	140	210	$120	$152.1K
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…	26	40	170	$90	$140.7K
S0280	Medical home program, comprehensive care coordination and planning, initial plan	10	20	820	$40	$138.9K
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…	80	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…	93	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.	40	250	240	$30	$72.7K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	50	90	320	$40	$58.8K

Showing 1–10 of 36

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shenandoah Medical Center	IA	Critical Access Hospital	$0	$2.4M
Sakeer Hussain	IA	Hematology & Oncology Physician	$1.9M	$0
Shyam Akkulugari	KS	Family Medicine Physician	$399.3K	$2.9K
Erik Otterberg	NE	Orthopaedic Surgery Physician	$204.2K	$0
Darren Keiser	NE	Orthopaedic Surgery Physician	$149.4K	$0
James Mantone	IA	Orthopaedic Surgery Physician	$107.5K	$0
Jeremy Pepin	IA	Nephrology Physician	$103.4K	$0
Mohamed Abdi	IA	Radiation Oncology Physician	$68.3K	$0
Michael Del Core	NE	Orthopaedic Hand Surgery Physician	$64K	$0
Kathleen Grier	NE	Orthopaedic Surgery Physician	$56.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nishna Productions, Inc.	IA	Community/Behavioral Health Agency	$0	$63.5M
Midwest Mental Health LLC	IA	Mental Health Counselor	$0	$4.8M
Shenandoah Ambulance Service	IA	Land Ambulance	$230.3K	$147.6K
Michael Morrison	IA	Orthopaedic Surgery Physician	$47.5K	$0
Michael Woods	IA	Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician	$6.6K	$0

Shenandoah Medical Center — 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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