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.

Ellsworth Municipal Hospital (NPI 1831296052)

Field	Value
Entity Type	Organization
Organization	Ellsworth Municipal Hospital
Address	920 South Oak St.
City	Iowa Falls
State	IA
ZIP	50126
Taxonomy	Critical Access Hospital
NPI Enumerated	September 20, 2006

Payer Source	Total Paid
Medicaid	$3.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

55 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	10,230	$140	$1.4M
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.	10,690	$100	$1.1M
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.	3,320	$60	$186K
T1015	Clinic visit/encounter, all-inclusive	2,180	$60	$137.4K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	2,010	$70	$132.7K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	8,560	$20	$128.4K
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.	460	$230	$104.7K
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.	2,940	$40	$102.9K
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…	3,450	$30	$89.8K
0241U	N/A	430	$210	$88.8K

Showing 1–10 of 55

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

Ellsworth Municipal Hospital — 1 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

55 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	210	330	3,960	$170	$2.8M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	31	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.	47	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.	83	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.	46	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.	47	90	320	$120	$327.7K
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…	387	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…	589	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.	50	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.	44	70	180	$60	$101.5K

Showing 1–10 of 55

Related Providers

Other providers that share a Tax Identification Number (TIN) with Ellsworth Municipal Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ellsworth Municipal Hospital	IA	Family Medicine Physician	$0	$1.2M
Aaron Heiar	IA	Family Medicine Physician	$200.8K	$0
Jagmeet Singh	PA	Nephrology Physician	$152.3K	$800
Mindy Gingery	IA	Psychiatric/Mental Health Nurse Practitioner	$25.1K	$0
Shannan Larson	IA	Certified Registered Nurse Anesthetist	$23.8K	$0
Dominic Formaro	IA	Surgery Physician	$20.2K	$0

Nearby Providers

Other providers in the same ZIP code as Ellsworth Municipal Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
City Of Iowa Falls	IA	Land Ambulance	$253K	$355.5K
Andrea Bartling	IA	Physician Assistant	$75.4K	$0
Brian Vold	IA	Psychiatric/Mental Health Nurse Practitioner	$32.5K	$11.3K

Ellsworth Municipal Hospital — Billing Profile & Reimbursement Data

Sign up for Ellsworth Municipal Hospital — Billing Profile & Reimbursement Data policy alerts

Ellsworth Municipal Hospital — Billing Profile & Reimbursement Data

Sign up for Ellsworth Municipal Hospital — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References