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.

Dhs-targeted Case Management (NPI 1588992994)

Field	Value
Entity Type	Organization
Organization	Dhs-targeted Case Management
Address	400 Sw 8th St
City	Des Moines
State	IA
ZIP	50309
Taxonomy	Case Management Agency
NPI Enumerated	November 23, 2009

Payer Source	Total Paid
Medicaid	$26.2M
Medicare	$0

Key Findings

This entity has no Medicare billing on file and instead reports $26.2M in lifetime Medicaid revenue, making it effectively a single-payer (Medicaid-focused) billing operation based on the available data. The absence of Medicare revenue contrasts sharply with the concentrated Medicaid activity documented for this provider.

Medicaid revenue is extremely concentrated: the precomputed top 3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue, with T1017 alone representing $21.1M (80.5%) and T1016 representing $5.1M (19.5%). This concentration indicates the organization’s financial model depends almost entirely on a very small set of time-based case management codes.

T1017 (Targeted case management, each 15 minutes) is the dominant service line by both volume and dollars, with 109.2K claims, a $193 avg paid/claim, and $21.1M revenue; it ranks #1 of 18 providers in-state and is labeled an extreme outlier. The high claim count and rank suggest this provider is delivering targeted case management at a scale far above typical state peers.

T1016 (Case management, each 15 minutes) is the secondary revenue driver with 11.9K claims, a $429 avg paid/claim, and $5.1M revenue; it also ranks #1 of 22 providers in-state and is described as notably above typical state volume. Together with T1017, T1016 confirms the organization bills primarily for time-based case management services rather than a broad mix of clinical procedures.

The presence of 706 claims for W1300 with a $0 avg paid/claim and $0 revenue—while still ranking #1 of 4 providers in-state—indicates some recorded activity for that code but no recorded Medicaid payments associated with it. Because W1300 contributes 0.0% of Medicaid revenue, it is operationally and financially immaterial compared with T1017 and T1016.

From a competitive-stance perspective, this provider is a dominant in-state player for its top codes: both T1017 and T1016 are rank #1 and at the 100th percentile among state peers. That standing implies market leadership in targeted and general case management services within the state, rather than a modest or typical participant.

The provider’s code mix—almost exclusively time-based case management codes (T1017 and T1016)—points to an operation focused on ongoing, episodic client support and care coordination, billing in 15-minute increments. The disparity between the two codes’ avg paid/claim ($193 for T1017 vs $429 for T1016) suggests different reimbursement rates or service-intensity distinctions within the case management lines.

This entity has an established presence: its NPI was enumerated on 2009-11-23 (~17 years ago), indicating long tenure in the provider landscape. The combination of long tenure and dominant in-state rankings for core case management codes suggests sustained, specialized service delivery rather than a recent or transient billing pattern.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1017	Targeted case management, each 15 minutes	109,210	$190	$21.1M
T1016	Case management, each 15 minutes	11,890	$430	$5.1M
W1300	N/A	710	$0	$0

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

Dhs-targeted Case Management — 2 of 2 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

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1017	Targeted case management, each 15 minutes	1	20	3,950	$160	$1.8M
T1016	Case management, each 15 minutes	1	20	480	$150	$340.3K
W1300	N/A	1	10	440	$0	$0

Nearby Providers

Other providers in the same ZIP code as Dhs-targeted Case Management, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Central Iowa Hospital Corporation	IA	General Acute Care Hospital	$0	$58M
Eyerly Ball Community Mental Health Services	IA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$57M
City Of Des Moines Iowa	IA	Land Ambulance	$1.1M	$47.2M
Orchard Place	IA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$30.5M
Woodward Youth Corporation	IA	Community/Behavioral Health Agency	$0	$28.2M
Central Iowa Hospital Corporation	IA	Pediatrics Physician	$0	$25.4M
Central Iowa Hospital Corporation	IA	Emergency Medicine Physician	$0	$13.1M
Orchard Place	IA	Adolescent and Children Mental Health Clinic/Center	$0	$6.6M
Robert Behrens	IA	Medical Oncology Physician	$5.2M	$0
Youth Emergency Services & Shelter Of Iowa	IA	Voluntary or Charitable Agency	$0	$4.7M

Dhs-targeted Case Management — Billing Profile & Reimbursement Data

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Dhs-targeted Case Management — 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

Nearby Providers

Frequently Asked Questions

References