Your Italy card went from Italy to Jefferson City, MO, stamped as received, then address corrected and re-postmarked at Jefferson City, then to Joplin where the flag added as a second receiving mark.
The Joplin flag was made by a machine of the American Postal Machines Co, which had several thousand installations in the US/territories making flags from 1894-1940, creating nearly 8000 different varieties. The best reference is Frederick Langford's "Standard Flag Cancel Encyclopedia" 4th ed, 2008. Your Joplin flag was the second of 3 different types used there. Worth maybe 50 cents for the cancel.
The intention was that cities would use the flag as an origin postmark then remove the flag portion and replace it with a "received" mark to mark incoming mail, but not all cities with flags had these extra die pieces, or chose not to use them. Receiving marks on standard first class mail were discontinued in 1912, although many larger towns had stopped several years eariler.
As an aside, Italy also had several towns using flag cancels (made by a different company):