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 1932539608)

Field	Value
Entity Type	Organization
Organization	Primary Health Care, Inc.
Address	3510 Lincoln Way
City	Ames
State	IA
ZIP	50014
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	November 18, 2013

Payer Source	Total Paid
Medicaid	$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.

69 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	32,410	$190	$6.3M
D0999	N/A	4,230	$250	$1M
D9999	N/A	4,920	$130	$649.8K
S0280	Medical home program, comprehensive care coordination and planning, initial plan	700	$40	$29.2K
D1351	Sealant - per tooth	570	$10	$2.8K
D1120	Prophylaxis–child	1,420	$1	$2.8K
D2391	Resin‑based composite – one surface, posterior	340	$10	$2.4K
D2392	Post 2 surface resin‑based composite	340	$10	$2.3K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	390	$10	$2.3K
D0120	Periodic oral evaluation - established patient	1,000	$1	$2K

Showing 1–10 of 69

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. — 0 of 23 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

69 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	50	330	3,960	$170	$2.8M
D9999	N/A	23	40	6,850	$180	$2.7M
D0999	N/A	20	30	6,470	$210	$1.8M
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	641	680	670	$70	$343.5K
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…	148	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…	118	1,310	760	$20	$153.1K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	133	140	210	$120	$152.1K
S0280	Medical home program, comprehensive care coordination and planning, initial plan	11	20	820	$40	$138.9K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	135	400	110	$100	$101.1K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	74	170	330	$50	$88.3K

Showing 1–10 of 69

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	$7.9M
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
Friendship Ark, Inc.	IA	In Home Supportive Care Agency	$0	$20.9M
Ames Community School District	IA	Local Education Agency (LEA)	$0	$10M
Timothy Hansen	IA	MOHS-Micrographic Surgery Physician	$517K	$0
Alexander Harvin	IA	Diagnostic Radiology Physician	$353.1K	$0
Daniel Feddersen	IA	Family Medicine Physician	$290.5K	$0
Hy-vee Inc	IA	Community/Retail Pharmacy	$178.3K	$37.3K
Timothy Lowry	IA	Family Medicine Physician	$181K	$0
Anne Snider	IA	Dermatology Physician	$175.8K	$0
Daniel Macalpine	IA	Dermatology Physician	$167.7K	$0
Charles Olson	IA	Diagnostic Radiology Physician	$153.5K	$0

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