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.

Mercy Clinics Inc (NPI 1912187311)

Mercy Clinics Inc is a clinic/center provider located in Clive, Iowa. This profile covers 0 Medicare and 15 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	Mercy Clinics Inc
Address	1601 Nw 114th St
City	Clive
State	IA
ZIP	50325
Taxonomy	Clinic/Center
NPI Enumerated	November 14, 2007

Payer Source	Total Paid
Medicaid	$1.7M
Medicare	$0

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99203	The provider sees a new 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 provider…	6,670	$70	$447K
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…	12,360	$30	$407.9K
99204	The provider sees a new 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 provider…	3,760	$100	$357.1K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	1,120	$180	$197.3K
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…	2,860	$50	$145.7K
92567	In this procedure, the provider measures the functioning of the middle ear by varying the pressure of air presented to the ear to identify the reason for hearing loss.	4,930	$20	$73.9K
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,…	650	$20	$15.5K
92587	Code 92587 is in the Medicine/Special Otorhinolaryngologic Services Section. It involves special procedures of the ears/nose/throat. This code is for screening purposes with interpretation and…	310	$40	$13.2K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	30	$200	$6.8K
31575	The provider uses a flexible laryngoscope to look inside the larynx, or voice box, to detect the presence of any abnormalities. This code applies to diagnostic services.	70	$70	$5.3K

Showing 1–10 of 15

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

Mercy Clinics Inc — 3 of 15 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

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	258	1,060	480	$40	$154.5K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	3	50	170	$410	$153.8K
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…	136	1,310	760	$20	$153.1K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	16	30	60	$750	$96.1K
92587	Code 92587 is in the Medicine/Special Otorhinolaryngologic Services Section. It involves special procedures of the ears/nose/throat. This code is for screening purposes with interpretation and…	10	30	210	$70	$47.7K
99204	The provider sees a new 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 provider…	8	250	110	$80	$47.1K
99203	The provider sees a new 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 provider…	11	430	110	$50	$36.1K
31231	In this procedure, the provider inserts an endoscope into the nasal cavity to examine the structures of the nasal cavity on one or both sides.	10	10	80	$70	$29.4K
92567	In this procedure, the provider measures the functioning of the middle ear by varying the pressure of air presented to the ear to identify the reason for hearing loss.	4	50	1,160	$10	$23K
31575	The provider uses a flexible laryngoscope to look inside the larynx, or voice box, to detect the presence of any abnormalities. This code applies to diagnostic services.	7	10	70	$90	$17.9K

Showing 1–10 of 15

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Union Associated Physicians Clinic, LLC	IN	Family Medicine Physician	$0	$31.1M
Mercy Clinics Inc	IA	Pediatric Adolescent Medicine Physician	$0	$10.7M
Mercy Clinics Inc	IA	Primary Care Clinic/Center	$0	$3.7M
Mercy Clinics, Inc.	IA	Primary Care Clinic/Center	$0	$2.9M
Mercy Clinics, Inc.	IA	Primary Care Clinic/Center	$0	$2.8M
Catholic Health Initiatives-iowa Corp	IA	Clinical Cardiac Electrophysiology Physician	$0	$2.8M
Mercy Clinics, Inc.	IA	Primary Care Clinic/Center	$0	$2.8M
Mercy Clinics, Inc	IA	Hospitalist Physician	$0	$2.5M
Mercy Clinics, Inc	IA	Maternal & Fetal Medicine Physician	$0	$2.4M
Mercy Clinics, Inc.	IA	Endocrinology, Diabetes & Metabolism Physician	$0	$2.3M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Iowa Family Assistants	IA	Home Health Agency	$0	$18M
Iowa Radiology, P C	IA	Diagnostic Radiology Physician	$0	$5.2M
Iowa Diagnostic Imaging & Procedure Center, L C	IA	Diagnostic Radiology Physician	$0	$2.5M
Iowa Endoscopy Center, Inc.	IA	Ambulatory Surgical Clinic/Center	$774K	$1.5M
West Lakes Surgery Center LLC	IA	Ambulatory Surgical Clinic/Center	$1.1M	$1.1M
Tara Graff	IA	Medical Oncology Physician	$1.4M	$0
Catholic Health Initiatives-iowa Corp	IA	Diagnostic Radiology Physician	$594.7K	$594.4K
Phippsburger Inc	IA	Home Health Agency	$0	$1.1M
Uhs Midwest Behavioral Health LLC	IA	Psychiatry Physician	$0	$979.3K
City Of Clive	IA	Land Ambulance	$157.3K	$820.4K

Mercy Clinics Inc — Billing Profile & Reimbursement Data

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Mercy Clinics 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

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