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 1982753273)

Field	Value
Entity Type	Organization
Organization	Primary Health Care, Inc.
Address	101 Iowa Ave W
City	Marshalltown
State	IA
ZIP	50158
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	January 9, 2007

Payer Source	Total Paid
Medicaid	$11.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

81 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	60,030	$190	$11.5M
S0280	Medical home program, comprehensive care coordination and planning, initial plan	910	$50	$41.8K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	960	$40	$38.2K
0513F	The provider documents a plan of care to manage elevated blood pressure in a patient with chronic kidney disease (CKD).	40	$20	$700
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	630	$1	$630
3079F	No Summary found for this code	490	$1	$490
3075F	No Summary found for this code	260	$1	$260
3077F	No Summary found for this code	210	$1	$210
3044F	The A1C test (HbA1C test) is a blood test which shows the levels of glucose (sugar) in the blood. The provider uses the test to determine if the patient’s diabetes is well controlled. The provider…	40	$1	$110
J1050	Injection, medroxyprogesterone acetate, 1 mg	30	$1	$60

Showing 1–10 of 81

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 11 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

81 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	21	330	3,960	$170	$2.8M
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…	626	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…	132	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…	44	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…	110	140	210	$120	$152.1K
S0280	Medical home program, comprehensive care coordination and planning, initial plan	9	20	820	$40	$138.9K
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…	60	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.	86	400	110	$100	$101.1K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	22	30	150	$110	$96.1K
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…	52	190	300	$50	$91.7K

Showing 1–10 of 81

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	$8M
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
Central Iowa Residential Services, Inc.	IA	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$50.3M
Wolfe Clinic Inc	IA	Ophthalmology Physician	$0	$18.2M
Unitypoint Health - Marshalltown	IA	General Acute Care Hospital	$0	$15.9M
Center Associates	IA	Cognitive & Behavioral Psychologist	$0	$8.8M
Marshalltown Community School District	IA	Local Education Agency (LEA)	$0	$6.9M
Unitypoint Health - Marshalltown	IA	Rural Health Clinic/Center	$0	$3.7M
Unitypoint Health - Marshalltown	IA	Emergency Medicine Physician	$0	$3.6M
Central Iowa Physio LLC	IA	Physical Therapy Clinic/Center	$0	$2.3M
Substance Abuse Treatment Unit Of Central Iowa	IA	Substance Abuse Rehabilitation Facility	$0	$1.6M
Region Six Planning Commission	IA	Bus	$0	$1.4M

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