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.

Audubon County Memorial Hospital (NPI 1851690432)

Audubon County Memorial Hospital is a rural health clinic/center provider located in Audubon, Iowa. This profile covers 0 Medicare and 13 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	Audubon County Memorial Hospital
Address	515 Pacific Ave
City	Audubon
State	IA
ZIP	50025
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	March 22, 2011

Payer Source	Total Paid
Medicaid	$1.1M
Medicare	$0

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	7,540	$140	$1.1M
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…	5,210	$1	$10.4K
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…	310	$1	$310
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	10	$1	$10
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	160	$0	$0
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	60	$0	$0
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	190	$0	$0
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	80	$0	$0
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,…	170	$0	$0
99307	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making or the…	10	$0	$0

Showing 1–10 of 13

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

Audubon County Memorial Hospital — 0 of 4 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

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	122	330	3,960	$170	$2.8M
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…	604	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…	253	1,310	760	$20	$153.1K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	141	250	240	$30	$72.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	207	250	110	$50	$39.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	225	290	100	$40	$17.2K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	372	570	110	$10	$11.4K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	179	190	250	$10	$11K
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,…	211	440	150	$10	$7.9K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	204	520	100	$10	$6.1K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Robert Behrens	IA	Medical Oncology Physician	$5.2M	$0
Lindsay Orris	IA	Internal Medicine Physician	$797.5K	$0
Kyle Ulveling	IA	Cardiovascular Disease Physician	$325.1K	$0
Shelby Mescher	IA	Nurse Practitioner	$125.2K	$0
Caliste Hsu	IA	Surgery of the Hand (Surgery) Physician	$82.4K	$0
Richard Goding	IA	Orthopaedic Surgery Physician	$78.5K	$0
Cynthia Wu	IA	Family Nurse Practitioner	$32K	$0
Matthew Nwaneri	MN	Medical Oncology Physician	$30.6K	$0
Mindy Gingery	IA	Psychiatric/Mental Health Nurse Practitioner	$25.1K	$0
Shannan Larson	IA	Certified Registered Nurse Anesthetist	$23.8K	$0

Audubon County Memorial Hospital — 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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