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.

Mercy Clinics, Inc (NPI 1699015503)

Mercy Clinics, Inc is a maternal & fetal medicine physician provider located in West Des Moines, Iowa. This profile covers 0 Medicare and 19 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	Mercy Clinics, Inc
Address	5901 Westown Pkwy Ste 225
City	West Des Moines
State	IA
ZIP	50266
Taxonomy	Maternal & Fetal Medicine Physician
NPI Enumerated	March 1, 2013

Payer Source	Total Paid
Medicaid	$2.4M
Medicare	$0

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	5,250	$150	$797.2K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	8,740	$50	$419.7K
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	3,000	$90	$272.5K
76801	In this procedure, the provider performs a real time or live image, ultrasound of a pregnant uterus for examination of the first or a single fetus and mother during the first trimester, or less than…	1,920	$100	$189.8K
76817	The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.	3,510	$50	$175.4K
76815	The provider performs a limited examination of the fetus using ultrasound. The provider performs the examination of certain parameters for one or more fetuses.	3,030	$50	$145.2K
76818	The provider performs a biophysical profile test to measure the health of the baby during pregnancy. The test consists of a nonstress test and an ultrasound.	1,810	$80	$139.3K
76813	The provider uses either a transabdominal or transvaginal ultrasound to measure the fetal nuchal translucency, or the clear, fluid–filled space at the back of the neck, of the first or a single…	910	$100	$86.6K
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	1,340	$50	$62.7K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	1,800	$30	$55.9K

Showing 1–10 of 19

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

Mercy Clinics, Inc — 5 of 19 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

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	2	10	3,460	$130	$479.9K
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…	961	1,060	480	$40	$154.5K
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…	938	1,310	760	$20	$153.1K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	4	20	100	$60	$71K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	4	60	210	$50	$69.4K
76818	The provider performs a biophysical profile test to measure the health of the baby during pregnancy. The test consists of a nonstress test and an ultrasound.	1	10	720	$70	$56.6K
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…	87	250	110	$80	$47.1K
99203	The provider sees a new 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 provider…	130	430	110	$50	$36.1K
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	2	10	440	$40	$27.7K
76813	The provider uses either a transabdominal or transvaginal ultrasound to measure the fetal nuchal translucency, or the clear, fluid–filled space at the back of the neck, of the first or a single…	1	10	80	$90	$25.7K

Showing 1–10 of 19

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Union Associated Physicians Clinic, LLC	IN	Family Medicine Physician	$0	$31.1M
Mercy Clinics Inc	IA	Pediatric Adolescent Medicine Physician	$0	$10.7M
Mercy Clinics Inc	IA	Primary Care Clinic/Center	$0	$3.7M
Mercy Clinics, Inc.	IA	Primary Care Clinic/Center	$0	$2.9M
Mercy Clinics, Inc.	IA	Primary Care Clinic/Center	$0	$2.8M
Catholic Health Initiatives-iowa Corp	IA	Clinical Cardiac Electrophysiology Physician	$0	$2.8M
Mercy Clinics, Inc.	IA	Primary Care Clinic/Center	$0	$2.8M
Mercy Clinics, Inc	IA	Hospitalist Physician	$0	$2.5M
Mercy Clinics, Inc.	IA	Endocrinology, Diabetes & Metabolism Physician	$0	$2.3M
Mercy Clinics, Inc.	IA	Primary Care Clinic/Center	$0	$2M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Iowa Physicians Clinic Medical Foundation	IA	General Practice Physician	$0	$102.7M
Link Associates	IA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$83.3M
Iowa Family Services, Inc	IA	Community/Behavioral Health Agency	$0	$9.9M
Revell-warrington Dental PC	IA	Pediatric Dentistry	$0	$9.2M
Csa	IA	Community/Behavioral Health Agency	$0	$8.8M
Kyle Alliman	IA	Ophthalmology Physician	$8.7M	$0
City Of West Des Moines	IA	Land Ambulance	$726.2K	$5.1M
Austin Strohbehn	IA	Retina Specialist (Ophthalmology) Physician	$5.8M	$0
Wolfe Surgery Center, LLC	IA	Ambulatory Surgical Clinic/Center	$4.1M	$1.3M
Iowa Home Care, LLC	IA	Home Health Agency	$0	$5.4M

Mercy Clinics, 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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