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.

Primary Health Care, Inc. (NPI 1720539091)

Field	Value
Entity Type	Organization
Organization	Primary Health Care, Inc.
Address	1200 University Ave Ste 100
City	Des Moines
State	IA
ZIP	50314
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	October 20, 2016

Payer Source	Total Paid
Medicaid	$7.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

31 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D9999	N/A	33,120	$190	$6.2M
D0999	N/A	6,890	$220	$1.5M
D0120	Periodic oral evaluation - established patient	8,710	$1	$34.8K
D1120	Prophylaxis–child	6,400	$10	$32K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	9,500	$1	$28.5K
D1999	N/A	100	$170	$16.5K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	3,410	$1	$13.6K
D2392	Post 2 surface resin‑based composite	820	$10	$11.5K
D0330	N/A	4,240	$1	$8.5K
D0150	Comprehensive oral evaluation – new or established patient	4,140	$1	$8.3K

Showing 1–10 of 31

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

Primary Health Care, Inc. — 3 of 24 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

31 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D9999	N/A	7	40	6,850	$180	$2.7M
D0999	N/A	13	30	6,470	$210	$1.8M
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	31	170	330	$50	$88.3K
D1351	Sealant - per tooth	61	190	750	$20	$60.2K
D2392	Post 2 surface resin‑based composite	60	210	230	$60	$58.6K
D4341	Periodontal scaling and root planing - four or more teeth per quadrant	18	50	210	$70	$46K
D1120	Prophylaxis–child	35	580	310	$20	$43.3K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	56	630	370	$30	$36.8K
D2391	Resin‑based composite – one surface, posterior	60	190	210	$40	$34.7K
D0120	Periodic oral evaluation - established patient	38	830	530	$20	$34.1K

Showing 1–10 of 31

Related Providers

Other providers that share a Tax Identification Number (TIN) with Primary Health Care, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Primary Health Care, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$15.6M
Primary Health Care, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$14.1M
Primary Health Care, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$12.1M
Primary Health Care, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$11.5M
Primary Health Care, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$8M
Primary Health Care, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$7.2M
Primary Health Care, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$5.3M
Primary Health Care, Inc.	IA	Federally Qualified Health Center (FQHC)	$0	$3.9M
Lazaro Rabang	IA	Internal Medicine Physician	$261.5K	$0
Duane Abbott	IA	Internal Medicine Physician	$50.3K	$0

Nearby Providers

Other providers in the same ZIP code as Primary Health Care, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Broadlawns Medical Center	IA	General Acute Care Hospital	$0	$112.9M
Catholic Health Initiatives-iowa Corp	IA	General Acute Care Hospital	$0	$26.4M
Des Moines Independent Community School District	IA	Local Education Agency (LEA)	$0	$22.8M
Broadlawns Medical Center	IA	Community/Behavioral Health Agency	$0	$13.2M
Mercy Clinics Inc	IA	Pediatric Adolescent Medicine Physician	$0	$10.7M
Des Moines River Physicians, LLC	IA	Emergency Medicine Physician	$0	$8.1M
Catholic Health Initiatives-iowa Corp	IA	Clinical Medical Laboratory	$0	$8M
Vita Health Services	IA	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$7.5M
House Of Mercy	IA	Substance Abuse Rehabilitation Facility	$0	$7.4M
Children And Families Of Iowa	IA	Substance Abuse Rehabilitation Facility	$0	$6.6M

Primary Health Care, Inc. — Billing Profile & Reimbursement Data

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Primary Health Care, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References