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.

East Idaho Orthopaedics, PLLC (NPI 1144413154)

Field	Value
Entity Type	Organization
Organization	East Idaho Orthopaedics, PLLC
Address	2210 Coronado St
City	Idaho Falls
State	ID
ZIP	83404
Taxonomy	Sports Medicine (Orthopaedic Surgery) Physician
NPI Enumerated	August 22, 2007

Payer Source	Total Paid
Medicaid	$525.4K
Medicare	$0

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	3,080	$80	$231.3K
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…	2,030	$60	$119.9K
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…	770	$120	$88K
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…	890	$80	$72.7K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	240	$40	$8.9K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	110	$40	$3.8K
J1040	Injection, methylprednisolone acetate, 80 mg	50	$10	$470
73100	In this procedure, the provider takes two X–ray images of a patient’s wrist to check for any fracture, swelling, or reason of pain in the wrist area.	10	$20	$340
J3301	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	20	$1	$50

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

East Idaho Orthopaedics, PLLC — 0 of 9 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

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	214	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…	120	620	560	$60	$191.8K
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…	30	220	90	$80	$51.4K
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…	19	180	70	$110	$45.6K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	62	210	90	$20	$10.4K
73100	In this procedure, the provider takes two X–ray images of a patient’s wrist to check for any fracture, swelling, or reason of pain in the wrist area.	5	10	330	$10	$4.4K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	7	20	80	$10	$2.8K
J3301	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	16	20	30	$10	$1.8K
J1040	Injection, methylprednisolone acetate, 80 mg	3	10	40	$10	$1K

Related Providers

Other providers that share a Tax Identification Number (TIN) with East Idaho Orthopaedics, PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Brigham Redd	ID	Orthopaedic Surgery Physician	$114.5K	$0
Joseph Liljenquist	ID	Sports Medicine (Orthopaedic Surgery) Physician	$91.9K	$0
Chad Coon	ID	Physician Assistant	$28.7K	$0
Chase Hanson	ID	Physician Assistant	$26.6K	$0
Jonathan Olson	ID	Orthopaedic Surgery Physician	$23.4K	$0

Nearby Providers

Other providers in the same ZIP code as East Idaho Orthopaedics, PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mountain View Hospital LLC	ID	General Acute Care Hospital	$0	$45.7M
Eastern Idaho Health Services Inc	ID	General Acute Care Hospital	$0	$12.1M
Rm Lab LLC	ID	Clinical Medical Laboratory	$1.1M	$8.2M
Medical Center For Children & Adolescents, PA	ID	Pediatrics Physician	$0	$8.8M
Aaa American Healthcare LLC	ID	Mental Health Counselor	$0	$8.7M
Intermountain Emergency Physicians	ID	Emergency Medicine Physician	$0	$6.6M
24-7 Professional Solutions	ID	In Home Supportive Care Agency	$0	$5.9M
Just 4 Kids Health LLC	ID	Urgent Care Clinic/Center	$0	$5.2M
Foothills Rehabilitation & Performance Services, PLLC	ID	Physical Therapist	$0	$5M
Innovative Health Care Concepts, Inc	ID	Developmental Disabilities Clinic/Center	$0	$4.8M

East Idaho Orthopaedics, PLLC — Billing Profile & Reimbursement Data

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East Idaho Orthopaedics, PLLC — 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