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.

Northwest Aea 12 (NPI 1871657908)

Field	Value
Entity Type	Organization
Organization	Northwest Aea 12
Address	1520 Morningside Ave
City	Sioux City
State	IA
ZIP	51106
Taxonomy	Local Education Agency (LEA)
NPI Enumerated	December 21, 2006

Payer Source	Total Paid
Medicaid	$2.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	64,040	$20	$1.1M
92508	The provider treats a group of two or more individuals with communication and hearing difficulties by directly interacting with them. He assesses the patients with impairment in their ability to make…	68,720	$10	$824.6K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	7,360	$20	$154.5K

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

Northwest Aea 12 — 2 of 3 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

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	1	60	2,110	$70	$570.5K
92508	The provider treats a group of two or more individuals with communication and hearing difficulties by directly interacting with them. He assesses the patients with impairment in their ability to make…	1	10	32,300	$10	$390.5K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	17	130	480	$30	$120.3K

Nearby Providers

Other providers in the same ZIP code as Northwest Aea 12, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mid-step Services, Inc.	IA	Developmentally Disabled Services Day Training Agency	$0	$51.5M
Michael Wadzinski	IA	Ophthalmology Physician	$4.8M	$0
Qualicenters Sioux City, LLC	IA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.5M
Prairie Pediatrics & Adolescent Clinic, P.C.	IA	Pediatric Cardiology Physician	$0	$1M
Daniel L Kaler Dds PC	IA	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$907K
Heather Longval	IA	Family Medicine Physician	$381.1K	$0
Bryce Robison	IA	Family Medicine Physician	$267.4K	$0
Delna Lee	IA	Family Medicine Physician	$225K	$0
Michael Jennings	IA	Family Medicine Physician	$188.3K	$0
Troy Fluent	IA	Chiropractor	$34.5K	$151.7K

Northwest Aea 12 — Billing Profile & Reimbursement Data

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Northwest Aea 12 — Billing Profile & Reimbursement Data

Sign up for Northwest Aea 12 — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References