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 1609956234)

Field	Value
Entity Type	Organization
Organization	State University Of Iowa
Address	322 Dental Science Bldg
City	Iowa City
State	IA
ZIP	52242
Taxonomy	Dentist
NPI Enumerated	October 17, 2006

Payer Source	Total Paid
Medicaid	$25.8M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-focused practice: Medicare revenue is listed as "none" (no Medicare billing on file) while Medicaid revenue totals $25.8M. The absence of Medicare billing makes the provider functionally single-payer in the dataset and means Medicaid policy and reimbursement dynamics will largely determine its financial exposure.

The provider has an established billing history, with the NPI enumerated on 2006-10-17 (~20 years ago). This length of tenure is consistent with a long-running operation and suggests the provider has had time to build stable referral and patient-volume patterns within the state Medicaid program.

Revenue is concentrated in a small set of high-revenue codes: the top three Medicaid codes (D7140 $2.8M, D8080 $1.4M, D3330 $1.3M) account for 26.3% of the provider's total Medicaid revenue. That concentration indicates material dependence on a handful of procedures for a quarter of Medicaid receipts, so changes to utilization or reimbursement for these specific codes could meaningfully affect topline Medicaid income.

The code mix points to a clinic that performs a mix of extractions and higher-cost procedures alongside high-volume preventive and diagnostic care. D7140 is explicitly an extraction (Extraction, erupted tooth or exposed root) and is the single largest-revenue code at $2.8M (13.1% of Medicaid revenue); the other two top codes, D8080 and D3330, carry elevated avg paid/claim values ($2701 and $481) which are consistent with higher-cost restorative or specialized services in the overall Medicaid revenue mix.

Competitive standing within Iowa is dominant on many routine and diagnostic codes. The provider ranks #1 of 631 for D1110 (25.8K claims, $42 avg, $1.1M, 5.1%), #1 of 265 for D0140 (38.7K claims, $27 avg, $1M, 5.0%), #1 of 150 for D0210 (13.8K claims, $50 avg, $692.1K, 3.3%), and #1 of 186 for D2391 (12K claims, $62 avg, $745.9K, 3.5%), with many of these listed as "extreme outlier" or 100th percentile—together these rankings indicate the provider is a major statewide source for preventive, diagnostic, and common restorative care under Medicaid.

Several codes reflect unusually high claim volumes relative to peers, consistent with the dataset labels of "extreme outlier" and "notably above typical state volume." Representative examples include D0140 at 38.7K claims, D0120 at 37.5K claims ($20 avg, $749.5K, 3.6%), D1206 at 39.1K claims ($18 avg, $704.4K, 3.3%), and D1351 at 32.5K claims ($24 avg, $779.6K, 3.7%). These high claim counts point to substantial patient throughput and routine service delivery at scale under Medicaid.

There is meaningful delivery of higher-cost restorative and prosthetic services in addition to high-volume preventive care. Codes with larger per-claim payments—D8080 ($2701 avg paid/claim, $1.4M, 6.9%), D5110 ($612 avg, $772.3K, 3.7%), D5120 ($634 avg, $393.1K, 1.9%), and D2740 ($442 avg, $510.1K, 2.4%)—show the provider also captures higher-reimbursed procedures, which helps diversify revenue beyond low-margin preventive codes.

From a payer-risk and business planning perspective, the combination of single-payer concentration (Medicaid $25.8M and no Medicare billing), heavy reliance on a few high-revenue codes (top 3 = 26.3%), and extremely high state ranking on many routine codes suggests both strengths and vulnerabilities: the provider is a dominant Medicaid participant in Iowa for many dental services, but its financial performance is tightly coupled to Medicaid utilization and reimbursement policies for the specific codes identified above.

Medicaid: Complete Services Breakdown

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

82 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	46,090	$60	$2.8M
D8080	N/A	540	$2,700	$1.4M
D3330	N/A	2,760	$480	$1.3M
D2930	N/A	10,940	$120	$1.3M
D7240	N/A	4,980	$240	$1.2M
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	25,750	$40	$1.1M
D0140	Limited oral evaluation – problem focused	38,710	$30	$1M
D2392	Post 2 surface resin‑based composite	9,630	$90	$828.1K
D1351	Sealant - per tooth	32,480	$20	$779.6K
D5110	N/A	1,260	$610	$772.3K

Showing 1–10 of 82

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 — 18 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

82 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D8080	N/A	3	20	300	$2,150	$877.9K
D3330	N/A	2	10	60	$420	$367.8K
D9243	N/A	3	10	1,340	$70	$239.6K
D5120	N/A	2	10	60	$540	$234K
D7240	N/A	1	20	180	$220	$228.7K
D5110	N/A	2	10	50	$530	$225.1K
D2930	N/A	2	80	850	$110	$217.2K
D0364	N/A	2	10	2,200	$100	$185.5K
D7230	N/A	2	10	300	$190	$169.9K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	5	40	310	$100	$162.7K

Showing 1–10 of 82

Related Providers

Other providers that share a Tax Identification Number (TIN) with State University Of Iowa, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
State University Of Iowa	IA	Family Medicine Physician	$0	$103.8M
State University Of Iowa	IA	General Acute Care Hospital	$0	$90.4M
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
Mercy Services Iowa City, Inc.	IA	Multi-Specialty Clinic/Center	$0	$2.4M
Bradley Hiatt	IA	Medical Oncology Physician	$2.2M	$0
State University Of Iowa	IA	Clinical Medical Laboratory	$1.5K	$1.9M

Nearby Providers

Other providers in the same ZIP code as State University Of Iowa, ranked by combined Medicare and Medicaid revenue.

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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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