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.

State University Of Iowa (NPI 1477554814)

Key Findings

Field	Value
Entity Type	Organization
Organization	State University Of Iowa
Address	200 Hawkins Dr
City	Iowa City
State	IA
ZIP	52242
Taxonomy	Family Medicine Physician
NPI Enumerated	August 9, 2005

Payer Source	Total Paid
Medicaid	$103.8M
Medicare	$0

This entity is effectively a Medicaid-focused biller: Total Medicare revenue is listed as none (no Medicare billing on file), while Total Medicaid revenue is $103.8M, indicating the provider’s recorded activity in the available claims data is concentrated in Medicaid rather than Medicare. Analysts should treat the profile as single-payer (Medicaid) for revenue and utilization comparisons.

Revenue is highly concentrated among a small set of Medicaid codes: the precomputed top 3 Medicaid codes by revenue account for 38.9% of this provider's total Medicaid revenue. The top three contributors are 99214 ($16.5M revenue, 20.6% of total Medicaid revenue), 99213 ($7.8M revenue, 9.8% of total Medicaid revenue), and H0040 ($6.8M revenue, 8.5% of total Medicaid revenue), so outpatient E/M and an ACT per-diem program together drive more than a third of recorded Medicaid revenue.

The code mix points to a broad, integrated clinical footprint rather than a narrow office-based practice: very high volumes for outpatient established-patient E/M codes (99214: 299.1K claims; 99213: 205.4K claims; 99215: 58K claims) coexist with substantial emergency and inpatient E/M activity (99285, 99284, 99283, 99232, 99233) and specialized neonatal/critical-care codes (99472, 99469, 99480, 99479). This combination implies the provider bills across ambulatory primary care, emergency services, inpatient follow-ups, and neonatal critical care.

Competitive standing within the state is dominant on many Medicaid codes: 99214 ranks #2 of 1063 providers in-state (100th percentile; extreme outlier), 99213 ranks #5 of 1312 providers (100th percentile; extreme outlier), and multiple high-revenue codes such as 99215, 99232, 99233, 93306, 70553, 88305, 96127, 71045, and 99291 are listed as #1 in-state and/or at the 100th percentile (described as extreme outlier or notably above typical). These rank/percentile signals indicate the provider is a major volume leader statewide for many core clinical and diagnostic services.

Neonatal and pediatric critical-care services are an important service line: 99472 ($5.8M revenue, 7.2% of total Medicaid revenue) ranks #1 of 3 providers in-state (100th percentile; typical, unremarkable volume for this code), while 99469 ($3.3M, 4.1%) and 99480 ($3.1M, 3.9%) both rank #1 of their peer counts and are described as notably above typical or notably above typical state volume. The presence of multiple high-revenue neonatal codes signals material NICU/neo-critical care throughput in the Medicaid population.

Behavioral-health capacity is visible but not exceptionally concentrated: H0040 (Assertive community treatment program, per diem) accounts for $6.8M revenue (8.5% of Medicaid revenue) and ranks #5 of 12 providers in-state (64th percentile; typical, unremarkable volume for this code), indicating an active ACT program billing presence without dominating the in-state market for that specific service. Analysts interested in community mental health should note this program-level revenue contribution alongside the strong general medical volumes.

Diagnostic and procedural services contribute meaningfully and show outlier volumes: 93306 (echo) $2M (2.5%) ranks #1 of 44 providers (100th percentile; extreme outlier), 70553 (MRI brain) $1.4M (1.8%) ranks #1 of 16 providers (100th percentile; extreme outlier), 88305 (surgical pathology) $1.8M (2.2%) ranks #1 of 94 providers (100th percentile; extreme outlier), and 95720 (EEG review) $2M (2.6%) ranks #1 of 3 providers (100th percentile; typical, unremarkable volume). These patterns point to substantial on-site imaging, pathology, and neurophysiology capacity driving Medicaid revenue.

Provider tenure and credentialing are long-standing: Taxonomy is Family Medicine Physician and the NPI was enumerated 2005-08-09 (~21 years ago), which indicates two decades of billing history under this NPI. Given the breadth of high-volume codes across ambulatory E/M, emergency, inpatient, neonatal, behavioral health, and diagnostics, the historic enumeration supports interpreting these patterns as established operational lines rather than a transient billing artifact.

Medicaid: Complete Services Breakdown

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

403 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	299,150	$60	$16.5M
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…	205,390	$40	$7.8M
H0040	Assertive community treatment program, per diem	100,300	$70	$6.8M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	13,770	$420	$5.8M
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.	30,460	$150	$4.6M
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	58,030	$80	$4.5M
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…	91,830	$50	$4.2M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	8,750	$370	$3.3M
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	24,610	$130	$3.1M
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…	36,230	$60	$2.2M

Showing 1–10 of 403

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

State University Of Iowa — 21 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

403 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0040	Assertive community treatment program, per diem	5	10	48,800	$60	$4.6M
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	32	60	16,120	$150	$3.8M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	1	10	600	$410	$2M
96159	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of a patient’s physical health…	65	70	3,810	$130	$1.1M
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.	42	280	850	$140	$801.8K
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	1	10	160	$340	$728.1K
95720	A physician or other QHCP reviews recorded events and analyzes spike and seizure detection of a continuous electroencephalography, a study of the electrical activity of the brain. A video is…	1	10	390	$480	$727.8K
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.	6	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.	27	310	1,320	$100	$543.4K
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	1	10	330	$120	$539.5K

Showing 1–10 of 403

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Annalee Fencl	IA	Student in an Organized Health Care Education/Training Program	$0	$2.5M
Brandon Syme	IA	General Practice Dentistry	$0	$1.3M
Lorna Grant	IA	Ophthalmology Physician	$1.2M	$0
State University Of Iowa	IA	Clinical Medical Laboratory	$163K	$338.8K
Tyler Risma	IA	Ophthalmology Physician	$423.2K	$0
Jessica Parkhurst	IA	Radiation Oncology Physician	$395.3K	$0
Amith George Jacob	IA	Critical Care Medicine (Internal Medicine) Physician	$178.2K	$216.1K
Leslie Christenson	IA	MOHS-Micrographic Surgery Physician	$354.2K	$0
Oluwaseun Adeola	IA	Clinical Cardiac Electrophysiology Physician	$345K	$0
Andrew Pugely	IA	Orthopaedic Surgery of the Spine Physician	$327.4K	$0

State University Of Iowa — Billing Profile & Reimbursement Data

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State University Of Iowa — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
State University Of Iowa	IA	General Acute Care Hospital	$0	$90.4M
State University Of Iowa	IA	Dentist	$0	$25.8M
Thomas Buroker	IA	Medical Oncology Physician	$9.4M	$0
State University Of Iowa	IA	Dentist	$0	$5.6M
Robert Behrens	IA	Medical Oncology Physician	$5.2M	$0
State University Of Iowa	IA	Psychologist	$0	$4.6M
Mission Cancer And Blood, PLLC	IA	Hematology & Oncology Physician	$0	$2.8M
Samuel Mehr	NE	Nuclear Medicine Physician	$2.5M	$0
Mercy Services Iowa City, Inc.	IA	Multi-Specialty Clinic/Center	$0	$2.4M
Bradley Hiatt	IA	Medical Oncology Physician	$2.2M	$0