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.

Winneshiek Medical Center (NPI 1619922051)

Winneshiek Medical Center is a critical access hospital provider located in Decorah, Iowa. This profile covers 0 Medicare and 35 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	Winneshiek Medical Center
Address	901 Montgomery St
City	Decorah
State	IA
ZIP	52101
Taxonomy	Critical Access Hospital
NPI Enumerated	May 24, 2006

Payer Source	Total Paid
Medicaid	$1.2M
Medicare	$0

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

35 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	5,390	$80	$404.5K
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…	2,300	$130	$291.5K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	1,410	$100	$139.9K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	2,710	$50	$138.4K
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.	380	$130	$48.4K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	2,140	$20	$45K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	640	$50	$29.9K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	340	$90	$28.8K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	10	$1,760	$24.7K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	1,310	$10	$15.8K

Showing 1–10 of 35

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

Winneshiek 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

35 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	59	70	1,440	$90	$2.8M
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.	166	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.	172	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.	73	310	1,320	$100	$543.4K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	60	90	320	$120	$327.7K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	54	60	210	$80	$186.8K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	49	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…	421	1,310	760	$20	$153.1K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	96	170	320	$20	$119.2K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	60	70	180	$60	$101.5K

Showing 1–10 of 35

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Paula Gill	WI	Hematology & Oncology Physician	$997.3K	$0
Brandon Riemer	MI	Ophthalmology Physician	$600K	$0
Sunil Khanna	MN	Ophthalmology Physician	$284K	$0
Titus Evans	MN	Cardiovascular Disease Physician	$223.9K	$0
Allan Jaffe	MN	Cardiovascular Disease Physician	$151.7K	$0
Robert Murphy	MN	Diagnostic Radiology Physician	$147K	$0
Matthew Thorpe	MN	Diagnostic Radiology Physician	$141.7K	$0
Mark Nathan	MN	Diagnostic Radiology Physician	$140K	$0
Thomas Gerber	MN	Cardiovascular Disease Physician	$126.1K	$0
Farris Timimi	MN	Advanced Heart Failure and Transplant Cardiology Physician	$124.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Opportunity Homes Inc	IA	Developmentally Disabled Services Day Training Agency	$0	$19.6M
Northeast Iowa Mental Health Center	IA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$7.7M
Choice Employment Services	IA	Community/Behavioral Health Agency	$0	$7.6M
Spectrum Industries	IA	Developmentally Disabled Services Day Training Agency	$0	$3.2M
Decorah Community School District	IA	Local Education Agency (LEA)	$0	$954.2K
Timothy Fechner	IA	Physical Therapist	$183.9K	$0
Daniel Wientzen	IA	Family Medicine Physician	$143.7K	$0
White Drug Enterprises Inc	IA	Community/Retail Pharmacy	$128.7K	$3.3K
Kurt Swanson	IA	Family Medicine Physician	$112.4K	$0
Janet Ryan	IA	Family Medicine Physician	$111.3K	$0

Winneshiek Medical Center — Billing Profile & Reimbursement Data

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Winneshiek 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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