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NPI 1154426104 · Idaho Falls, ID · State or Local Public Health Clinic/Center
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Eastern Idaho Public Health is a state or local public health clinic/center provider located in Idaho Falls, Idaho. This profile covers 12 Medicare and 9 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Eastern Idaho Public Health |
| Address | 1250 Hollipark Drive |
| City | Idaho Falls |
| State | ID |
| ZIP | 83401 |
| Taxonomy | State or Local Public Health Clinic/Center |
| NPI Enumerated | September 14, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $404.9K |
| Medicaid | $34.2K |
Eastern Idaho Public Health’s Medicare revenue is concentrated in vaccination services: the top three Medicare codes are 91320, 90662, and 90677, and these three codes together account for 72.3% of the provider’s total Medicare revenue. Individually, 91320 generated $144.8K (35.8% of Medicare revenue) across 1.2K claims, 90662 generated $91K (22.5%) across 1.4K claims, and 90677 generated $56.3K (13.9%) across 225 claims, indicating an operational focus on COVID-19, influenza, and pneumococcal immunization delivery to Medicare beneficiaries.
The provider’s Medicaid activity is dominated by a small set of dental/preventive codes: D0191, D1351, and D1206 make up 100.0% of reported Medicaid revenue. D0191 accounts for $26.3K (76.0% of Medicaid revenue) on 1.6K claims, D1351 contributes $6.6K (19.1%) on 331 claims, and D1206 contributes $1.7K (4.9%) on 1.7K claims, signaling that Medicaid-facing services are concentrated in dental preventive care and sealants within this public health clinic.
Payer mix is heavily skewed toward Medicare by scale: lifetime Medicare revenue is $404.9K versus lifetime Medicaid revenue of $34.2K, so the organization is effectively Medicare-dominant in dollar terms while still offering distinct Medicaid dental services. This gap suggests the clinic’s primary revenue-driving operations are immunization programs billed to Medicare while Medicaid revenue supports a smaller, prevention-focused dental line.
National competitive standing for the clinic’s leading Medicare vaccine codes places it high in rank lists but the activity is characterized as typical among peers. For example, 91320 ranks #35 of 27083 providers nationally (100th percentile) and 90662 ranks #24 of 70752 (100th percentile), yet both are labeled as “typical, unremarkable volume,” which implies the provider is visible in national rankings for vaccine administration but not an outlier in clinical practice patterns.
At the state level the provider is a modest participant in Medicaid dental services rather than a dominant statewide player. D0191 ranks #4 of 9 in-state (63th percentile), D1351 ranks #79 of 124 (37th percentile), and D1206 ranks #46 of 209 (78th percentile), indicating above-median presence for some preventive services but generally mid-tier statewide performance in dental-related billing.
Tenure data show the NPI was enumerated on 2006-09-14 (~20 years ago), indicating a long-established public health entity. The multi-year presence aligns with a stable service mix focused on community immunizations and Medicaid preventive dentistry rather than recent startup activity.
There are mixed signals on narrower code participation: several Medicare vaccine administration codes (G0008, 90480) also appear among the top billers, reinforcing the immunization service line, while hepatitis B administration (G0010) is comparatively low-ranked at #265 of 323 providers nationally (13th percentile), suggesting limited hepatitis B vaccination activity in the Medicare population. These relative weaknesses in some vaccine types may indicate targeted program priorities rather than broad-spectrum vaccine delivery.
The Medicaid dataset includes multiple codes with a $0 avg paid/claim (0012A, 0002A, 91300, 91301, 0001A, 0011A) appearing on the file alongside paid codes; this pattern could reflect program-supplied vaccines, zero-dollar administrative entries, or reporting practices specific to certain payers. Analysts should treat those zero-paid code lines as distinct from the revenue-driving Medicaid codes (D0191, D1351, D1206) when assessing financial impact and service volume.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
12 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 91320 | This code represents a SARS–CoV–2 vaccine product (tris–sucrose formulation) administered by intramuscular injection to reduce the patient’s risk of contracting COVID–19. The dosage is 30 mcg/0.3 mL. | 1,240 | $120 | $144.8K |
| 90662 | This code represents a flu vaccine product that is a split virus type, contains no preservatives, and has enhanced effectiveness due to a higher antigen content. It is administered as an injection… | 1,450 | $60 | $91K |
| 90677 | This code represents a vaccine product administered intramuscularly to protect against pneumococcal disease, a bacterial infection. This is a 20–valent vaccine, protecting against 20 strains of the… | 230 | $250 | $56.3K |
| G0008 | Administration of influenza virus vaccine | 1,540 | $30 | $43K |
| 90480 | The provider administers the first or only component of a SARS–CoV–2 (COVID–19) vaccine by intramuscular injection to reduce the patient's risk of contracting COVID–19. | 1,250 | $30 | $42.3K |
| 0124A | N/A | 240 | $40 | $9.2K |
| G0009 | Administration of pneumococcal vaccine | 270 | $30 | $7.5K |
| 90732 | The provider intramuscularly or subcutaneously injects pneumococcal polysaccharide vaccine in an individual two years or older. This vaccine provides protection against meningitis and pneumonia that… | 40 | $120 | $4.8K |
| 0134A | N/A | 70 | $40 | $2.6K |
| 90686 | This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL… | 70 | $20 | $1.3K |
Showing 1–10 of 12
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
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 |
|---|---|---|---|---|
| D0191 | N/A | 1,640 | $20 | $26.3K |
| D1351 | Sealant - per tooth | 330 | $20 | $6.6K |
| D1206 | Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients | 1,700 | $1 | $1.7K |
| 0001A | N/A | 40 | $0 | $0 |
| 0002A | N/A | 20 | $0 | $0 |
| 0011A | N/A | 30 | $0 | $0 |
| 0012A | N/A | 30 | $0 | $0 |
| 91300 | N/A | 60 | $0 | $0 |
| 91301 | N/A | 50 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Idaho providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Idaho median
9 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| D0191 | N/A | 4 | 10 | 1,560 | $10 | $28.5K |
| 0002A | N/A | 28 | 30 | 80 | $40 | $14.7K |
| 0001A | N/A | 26 | 40 | 70 | $30 | $13.4K |
| D1351 | Sealant - per tooth | 79 | 120 | 640 | $1 | $10.3K |
| 0012A | N/A | 16 | 40 | 30 | $30 | $3.4K |
| 0011A | N/A | 17 | 30 | 30 | $20 | $2.8K |
| D1206 | Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients | 46 | 210 | 320 | $1 | $1.6K |
| 91300 | N/A | 26 | 40 | 200 | $0 | $0 |
| 91301 | N/A | 15 | 30 | 50 | $0 | $0 |
Other providers in the same ZIP code as Eastern Idaho Public Health, ranked by combined Medicare and Medicaid revenue.
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