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.

North Idaho Day Surgery LLC (NPI 1104824739)

North Idaho Day Surgery LLC is a general acute care hospital provider located in Post Falls, Idaho. This profile covers 0 Medicare and 33 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	North Idaho Day Surgery LLC
Address	1593 E Polston Ave
City	Post Falls
State	ID
ZIP	83854
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 8, 2005

Payer Source	Total Paid
Medicaid	$1.2M
Medicare	$0

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

33 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…	9,520	$50	$485.5K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	10,240	$40	$399.3K
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…	2,930	$50	$149.3K
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…	1,430	$80	$118.3K
99204	The provider sees a new 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 provider…	130	$90	$11.3K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	30	$290	$8.4K
72148	In this diagnostic procedure, the provider performs magnetic resonance imaging (MRI) of the lumbar spinal canal and contents without using contrast.	90	$80	$7.5K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	50	$110	$5.4K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	260	$20	$3.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	40	$100	$3.7K

Showing 1–10 of 33

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

North Idaho Day Surgery LLC — 0 of 25 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

33 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	34	40	530	$70	$237.8K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	8	20	4,340	$10	$236.8K
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…	70	670	740	$40	$193.6K
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…	128	620	560	$60	$191.8K
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…	77	80	450	$80	$171.3K
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…	68	80	380	$70	$151.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	61	80	130	$80	$91.4K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	27	40	180	$170	$75K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	98	140	100	$90	$54.4K
73721	In this diagnostic procedure, the provider performs magnetic resonance imaging of a lower extremity joint without using contrast material.	12	10	350	$70	$54.4K

Showing 1–10 of 33

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Daniel Blizzard	ID	Orthopaedic Surgery of the Spine Physician	$201.1K	$0
Roland Kent	ID	Orthopaedic Surgery of the Spine Physician	$179.7K	$0
Sai Alla	ID	Anesthesiology Physician	$118.8K	$0
Jessica Jameson	ID	Pain Medicine (Anesthesiology) Physician	$106.2K	$0
Michael James	ID	Gastroenterology Physician	$95.7K	$0
John Pennings	ID	Surgery Physician	$89.9K	$0
David Glassman	ID	Orthopaedic Surgery of the Spine Physician	$89.3K	$0
Antoine Sarkis	ID	Surgery Physician	$84.2K	$0
Michael Coats	ID	Sleep Medicine (Psychiatry & Neurology) Physician	$73.6K	$0
Hollys Nielsen	ID	Nurse Practitioner	$65K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dirne Health Centers, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$6.3M
Kootenai County	ID	Local Education Agency (LEA)	$0	$5.2M
Learning Garden Developmental Preschool	ID	Developmentally Disabled Services Day Training Agency	$0	$3.1M
Danko Martincic	ID	Hematology & Oncology Physician	$2.6M	$0
Aaging Better In-home Care, LLC	ID	Home Health Agency	$0	$2.4M
Little Smiles Pediatric Dentistry PC	ID	Pediatric Dentistry	$0	$2.2M
Pleasant View Surgery Center, LLC	ID	Ambulatory Surgical Clinic/Center	$1M	$0
Corbin Jacobs	ID	Radiation Oncology Physician	$915.1K	$0
Tandy Therapy LLC	ID	Speech-Language Pathologist	$0	$780.1K
Post Falls Asc, L.L.C.	ID	Ambulatory Surgical Clinic/Center	$0	$734K

North Idaho Day Surgery LLC — Billing Profile & Reimbursement Data

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North Idaho Day Surgery LLC — 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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