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.

Madison County Memorial Hospital (NPI 1962567990)

Field	Value
Entity Type	Organization
Organization	Madison County Memorial Hospital
Address	300 W Hutchings St Ste 100&110
City	Winterset
State	IA
ZIP	50273
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	December 27, 2006

Payer Source	Total Paid
Medicaid	$4.6M
Medicare	$0

Medicaid: Complete Services Breakdown

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	33,750	$140	$4.6M
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…	19,950	$1	$39.9K
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…	4,100	$10	$24.6K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	20	$40	$530
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	190	$1	$190
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…	10	$10	$80
0001A	N/A	10	$1	$30
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	140	$0	$0
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	530	$0	$0
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	2,900	$0	$0

Showing 1–10 of 22

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

Madison County Memorial Hospital — 0 of 7 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

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	46	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…	204	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…	87	1,310	760	$20	$153.1K
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…	99	170	540	$50	$101.2K
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…	99	190	300	$50	$91.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	83	250	110	$50	$39.9K
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…	396	430	110	$50	$36.1K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	106	300	250	$10	$19.6K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	107	290	100	$40	$17.2K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	60	570	110	$10	$11.4K

Showing 1–10 of 22

Related Providers

Other providers that share a Tax Identification Number (TIN) with Madison County Memorial Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Abdelaziz Elhaddad	IA	Medical Oncology Physician	$1.5M	$0
Amy Hughes	IA	Medical Oncology Physician	$167.1K	$0
Matthew Mccormick	IA	Cardiovascular Disease Physician	$162.7K	$0
Daniel Moyse	IA	Pain Medicine (Anesthesiology) Physician	$121.4K	$0
Bradley Wilcox	IA	Pulmonary Disease Physician	$98.9K	$0
Eric Asbe	IA	Pulmonary Disease Physician	$86.5K	$0
Steven Aviles	IA	Orthopaedic Surgery Physician	$76.8K	$0
Ashlee Reetz	IA	Physician Assistant	$73K	$0
Bryon Johnson	IA	Pulmonary Disease Physician	$69.7K	$0
Kara Buckingham	IA	Physician Assistant	$36.5K	$0

Nearby Providers

Other providers in the same ZIP code as Madison County Memorial Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Turning Point Evaluation, Inc.	IA	Counselor	$0	$2.5M
Winterset Community School District	IA	Local Education Agency (LEA)	$0	$1.3M
County Of Madison	IA	Land Ambulance	$141.1K	$54.7K
Grx Holdings LLC	IA	Community/Retail Pharmacy	$65.2K	$3.4K

Madison County Memorial Hospital — Billing Profile & Reimbursement Data

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Madison 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

Related Providers

Nearby Providers

Frequently Asked Questions

References