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.

Grinnell Regional Medical Center (NPI 1437663242)

Grinnell Regional Medical Center is a family medicine physician provider located in Grinnell, Iowa. This profile covers 0 Medicare and 44 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	Grinnell Regional Medical Center
Address	210 4th Ave
City	Grinnell
State	IA
ZIP	50112
Taxonomy	Family Medicine Physician
NPI Enumerated	December 1, 2017

Payer Source	Total Paid
Medicaid	$862.9K
Medicare	$0

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

44 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…	7,900	$30	$237K
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.	3,020	$80	$235.8K
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…	2,030	$50	$95.2K
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.	1,450	$50	$77.1K
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…	690	$90	$61.8K
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.	330	$110	$37.8K
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.	460	$50	$20.7K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	150	$120	$19K
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…	180	$70	$13K
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…	190	$60	$11.3K

Showing 1–10 of 44

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

Grinnell Regional Medical Center — 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

44 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	77	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.	91	180	340	$170	$722K
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.	145	310	1,320	$100	$543.4K
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…	300	1,060	480	$40	$154.5K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	29	50	170	$410	$153.8K
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…	190	1,310	760	$20	$153.1K
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.	53	60	260	$210	$109.2K
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…	109	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…	151	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.	98	250	240	$30	$72.7K

Showing 1–10 of 44

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grinnell Regional Medical Center	IA	General Acute Care Hospital	$0	$2.2M
Steven Heddinger	IA	Medical Oncology Physician	$830.4K	$0
Melisa Coaker	IA	Sleep Medicine (Internal Medicine) Physician	$370.4K	$0
Brian Heineman	IA	Adolescent Medicine (Family Medicine) Physician	$142.7K	$224.8K
Hamad Azam	IA	Pulmonary Disease Physician	$163.2K	$0
Hafiz Rizwan Talib Hashmi	IA	Pulmonary Disease Physician	$151.8K	$0
Vijaya Gogineni	IA	Pulmonary Disease Physician	$130.9K	$0
Brian Lindsay	IA	Pulmonary Disease Physician	$106.7K	$0
Trevor Wild	IA	Urology Physician	$99.7K	$0
Suren Ravuri	WI	Hospitalist Physician	$88.3K	$6K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grinnell Regional Medical Center	IA	Rural Health Clinic/Center	$0	$5.6M
Matthew Mcknight	IA	Foot & Ankle Surgery Podiatrist	$4.7M	$23.5K
Davis Psychological Services, PC	IA	Counseling Psychologist	$0	$1.2M
Healthy Homes Family Services, Inc	IA	Mental Health Counselor	$0	$1.1M
Hy-vee Inc	IA	Community/Retail Pharmacy	$214.5K	$49.1K
Brandon Davis	IA	Psychologist	$75.8K	$0
Linda Davis	IA	Occupational Therapist	$41.4K	$0
Jacqueline Weydert	IA	Clinical Social Worker	$36.8K	$0
Corinne Fogle	IA	Medical Physician Assistant	$12.3K	$0
Ryan Hargraves	IA	Psychiatry Physician	$5.6K	$0

Grinnell Regional Medical Center — Billing Profile & Reimbursement Data

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Grinnell Regional 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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