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.

St Anthony Regional Hospital And Nursing Home (NPI 1720067127)

Field	Value
Entity Type	Organization
Organization	St Anthony Regional Hospital And Nursing Home
Address	311 S Clark St
City	Carroll
State	IA
ZIP	51401
Taxonomy	Critical Access Hospital
NPI Enumerated	January 13, 2006

Payer Source	Total Paid
Medicaid	$1.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

44 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.	4,010	$140	$549.2K
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.	1,860	$210	$391.2K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	30	$4,630	$120.5K
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.	1,040	$90	$95.8K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	4,070	$20	$93.7K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	80	$880	$70.6K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	170	$100	$17.1K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	200	$80	$17.1K
J7030	Infusion, normal saline solution , 1000 cc	200	$60	$11.3K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	190	$60	$10.9K

Showing 1–10 of 44

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

St Anthony Regional Hospital And Nursing Home — 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

44 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	24	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.	97	280	850	$140	$801.8K
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.	94	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.	57	90	320	$120	$327.7K
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	47	50	130	$320	$224.4K
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…	970	1,060	480	$40	$154.5K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	34	50	170	$410	$153.8K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	18	30	60	$750	$96.1K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	17	30	200	$110	$85.8K
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.	46	180	290	$70	$66.9K

Showing 1–10 of 44

Related Providers

Other providers that share a Tax Identification Number (TIN) with St Anthony Regional Hospital And Nursing Home, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Robert Behrens	IA	Medical Oncology Physician	$5.2M	$0
James Stafford	TX	Radiation Oncology Physician	$1.5M	$0
St Anthony Regional Hospital And Nursing Home	IA	Family Medicine Physician	$0	$1.1M
Boris Naydich	MD	Radiation Oncology Physician	$892.3K	$0
Joshua Lukenbill	IA	Medical Oncology Physician	$534.1K	$0
Said Sana	WV	Family Medicine Physician	$424.4K	$0
Matthew Carpenter	IL	Radiation Oncology Physician	$420.8K	$0
Robert Isaak	IA	Radiation Oncology Physician	$172.7K	$0
Adam Althaus	SD	Urology Physician	$137.7K	$0

Nearby Providers

Other providers in the same ZIP code as St Anthony Regional Hospital And Nursing Home, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Carroll Co Council Prev Child Abuse	IA	Community/Behavioral Health Agency	$0	$51M
New Hope Village, Inc	IA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$50.2M
Ability United LLC	IA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$43.8M
Homecare Options, Inc.	IA	Contractor	$0	$9.1M
Caring Hearts Of West Central Iowa	IA	Community Health Worker	$0	$3.4M
Region Xii Council Of Governments, Inc.	IA	Non-emergency Medical Transport (VAN)	$0	$1.9M
Carroll Community School District	IA	Local Education Agency (LEA)	$0	$1.3M
Carroll County County Auditor	IA	Ambulance	$344K	$824.9K
Carroll Dental Clinic P.l.c.	IA	Dentist	$0	$1.1M
Wellendorf Ent, P.C.	IA	Otolaryngology Physician	$0	$932.9K

St Anthony Regional Hospital And Nursing Home — Billing Profile & Reimbursement Data

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St Anthony Regional Hospital And Nursing Home — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References