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.

Orange City Municipal Hospital (NPI 1962477992)

Orange City Municipal Hospital is a family medicine physician provider located in Orange City, Iowa. This profile covers 0 Medicare and 28 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	Orange City Municipal Hospital
Address	1000 Lincoln Cir Se
City	Orange City
State	IA
ZIP	51041
Taxonomy	Family Medicine Physician
NPI Enumerated	February 22, 2006

Payer Source	Total Paid
Medicaid	$879.9K
Medicare	$0

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

28 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	18,010	$30	$594.2K
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…	910	$50	$45.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	3,360	$10	$36.9K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	490	$70	$32.7K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	340	$80	$25.9K
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.	340	$50	$17.9K
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…	220	$80	$17.5K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	750	$20	$17.3K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	430	$40	$16.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	200	$80	$16K

Showing 1–10 of 28

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

Orange City Municipal Hospital — 0 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

28 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	219	310	1,320	$100	$543.4K
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…	478	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…	433	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…	98	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…	114	140	210	$120	$152.1K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	473	610	550	$70	$145.9K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	86	170	540	$50	$101.2K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	239	400	110	$100	$101.1K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	92	190	300	$50	$91.7K
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.	177	180	290	$70	$66.9K

Showing 1–10 of 28

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rafik Ben Abda	FL	Diagnostic Radiology Physician	$743.9K	$0
Wesley Pruett	MN	Diagnostic Radiology Physician	$441.3K	$770
David Daniels	SD	Urology Physician	$307.9K	$0
Richard Wilson	MN	Diagnostic Radiology Physician	$304.5K	$0
Arlene Sussman	MN	Diagnostic Radiology Physician	$242.3K	$29.9K
Brendan Miner	MN	Diagnostic Radiology Physician	$225.6K	$11.2K
Hetal Verma	MA	Diagnostic Radiology Physician	$41.5K	$178.3K
Scott Sullivan	CT	Diagnostic Radiology Physician	$219K	$0
Muhammad Abdul-wahab	IA	Diagnostic Radiology Physician	$179.1K	$0
Sergey Shkurovich	MN	Diagnostic Radiology Physician	$162.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Family Solutions Services 1, Inc.	IA	Community/Behavioral Health Agency	$0	$6M
Moc-floyd Valley Csd	IA	Local Education Agency (LEA)	$0	$2.6M
Family Solutions Services, Inc.	IA	Community/Behavioral Health Agency	$0	$2.4M
Jonathan Groskreutz	IA	Physical Therapist	$57.2K	$0
Kurtis Korver	IA	Otolaryngology Physician	$34.3K	$0
Gail Bolton	IA	Audiologist	$8.7K	$0

Orange City Municipal Hospital — Billing Profile & Reimbursement Data

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Orange City Municipal 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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