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.

Covenant Medical Center Inc (NPI 1548288160)

Covenant Medical Center Inc is a family medicine physician provider located in Waterloo, Iowa. This profile covers 0 Medicare and 156 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	Covenant Medical Center Inc
Address	3421 W 9th St
City	Waterloo
State	IA
ZIP	50702
Taxonomy	Family Medicine Physician
NPI Enumerated	July 18, 2006

Payer Source	Total Paid
Medicaid	$21.9M
Medicare	$0

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

156 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…	247,140	$30	$6.2M
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…	126,340	$40	$4.4M
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…	14,400	$110	$1.6M
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	15,810	$80	$1.2M
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…	12,800	$80	$998.6K
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…	14,320	$70	$988K
90834	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…	11,420	$60	$673.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	8,270	$80	$645.2K
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…	7,450	$70	$499.2K
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…	10,040	$40	$351.4K

Showing 1–10 of 156

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

Covenant Medical Center 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

156 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	6	10	2,020	$140	$527.6K
90834	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…	64	680	670	$70	$343.5K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	7	40	900	$90	$249.3K
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…	14	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…	4	1,060	480	$40	$154.5K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	30	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…	2	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…	2	140	210	$120	$152.1K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	13	610	550	$70	$145.9K
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	40	170	$90	$140.7K

Showing 1–10 of 156

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Covenant Medical Center Inc	IA	General Acute Care Hospital	$0	$63.2M
Covenant Medical Center Inc	IA	Durable Medical Equipment & Medical Supplies	$0	$2.1M
Mercy Hospital Of Franciscan Sisters Inc	IA	Critical Access Hospital	$0	$2M
Jay Robinow	KS	Radiation Oncology Physician	$1.2M	$0
Andrew Pugely	IA	Orthopaedic Surgery of the Spine Physician	$327.4K	$0
Ahsan Maqsood	IA	Interventional Cardiology Physician	$324.4K	$0
Victor Abrich	IA	Clinical Cardiac Electrophysiology Physician	$213.3K	$0
Ravinder Dervesh	IA	Interventional Cardiology Physician	$196.9K	$0
Brendan Coutu	IA	Radiation Oncology Physician	$193.3K	$0
Richard Valente	IA	Cardiovascular Disease Physician	$182.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Black Hawk-grundy Mental Health Center Inc.	IA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$20.7M
Waterloo Community School District	IA	Local Education Agency (LEA)	$0	$19.8M
Iowa Emergency Physicians LLP	IA	Emergency Medicine Physician	$0	$5.1M
Jyoti Chowdhury	IA	Pediatric Dentistry	$0	$2.4M
Michael Letkewicz	IA	Oral and Maxillofacial Surgery (Dentist)	$0	$1.7M
Metropolitan Transit Authority Of Black Hawk County	IA	Bus	$0	$1.7M
Michael Puk	IA	Ophthalmology Physician	$1.6M	$0
Carol Halloran	IA	Dentist	$0	$1.6M
Panther Ventures LLC	IA	Non-emergency Medical Transport (VAN)	$0	$1.3M
Thomas Petrie	IA	Ophthalmology Physician	$1.2M	$330

Covenant Medical Center 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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