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 Idaho for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Idaho 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. Idaho (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.

Middleton School District (NPI 1013056480)

Field	Value
Entity Type	Organization
Organization	Middleton School District
Address	5 S 3rd Ave W
City	Middleton
State	ID
ZIP	83644
Taxonomy	Local Education Agency (LEA)
NPI Enumerated	February 5, 2007

Payer Source	Total Paid
Medicaid	$3.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	6,920	$170	$1.2M
H2014	Skills training and development, per 15 minutes	17,730	$50	$833.4K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	18,710	$20	$374.3K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	6,340	$50	$285.3K
96152	N/A	770	$180	$140.9K
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	3,160	$40	$120K
H2017	Psychosocial rehabilitation services, per 15 minutes	620	$180	$111.1K
92508	The provider treats a group of two or more individuals with communication and hearing difficulties by directly interacting with them. He assesses the patients with impairment in their ability to make…	7,670	$10	$53.7K
A0080	Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest	3,760	$10	$26.3K
99412	The provider offers advice on maintaining and improving health to a group of patients for roughly an hour.	890	$30	$23.2K

Showing 1–10 of 14

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Idaho providers billing the same CPT/HCPCS codes.

Claims Volume vs. Idaho Distribution

Middleton School District — 0 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

14 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	79	100	11,400	$80	$2M
H0004	Behavioral health counseling and therapy, per 15 minutes	63	160	4,020	$140	$1.6M
H2017	Psychosocial rehabilitation services, per 15 minutes	102	140	2,000	$110	$633.3K
H2014	Skills training and development, per 15 minutes	9	60	2,500	$60	$613.3K
96152	N/A	59	70	2,270	$80	$608.8K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	62	280	1,480	$70	$389.4K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	21	210	3,020	$50	$389K
99412	The provider offers advice on maintaining and improving health to a group of patients for roughly an hour.	9	10	3,060	$30	$172.5K
T1001	Nursing assessment / evaluation	40	50	260	$60	$77K
92508	The provider treats a group of two or more individuals with communication and hearing difficulties by directly interacting with them. He assesses the patients with impairment in their ability to make…	22	90	2,700	$10	$59.3K

Showing 1–10 of 14

Nearby Providers

Other providers in the same ZIP code as Middleton School District, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Icare Supported Living, Inc.	ID	In Home Supportive Care Agency	$0	$13M
Daniel Allen	ID	Family Medicine Physician	$493.7K	$0
Foundations Pediatric Therapy PLLC	ID	Pediatric Occupational Therapist	$0	$443.8K
Samuel Hally	ID	Family Nurse Practitioner	$128.1K	$0
Rebecca Swainston	ID	Family Nurse Practitioner	$58.5K	$0
Jonathan Hughes	ID	Optometrist	$30.9K	$0

Middleton School District — Billing Profile & Reimbursement Data

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Middleton School District — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References