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.

Bmh Inc (NPI 1174091896)

Bmh Inc is a family medicine physician provider located in Idaho Falls, Idaho. This profile covers 0 Medicare and 15 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	Bmh Inc
Address	1533 N Sunstone Dr Ste A
City	Idaho Falls
State	ID
ZIP	83401
Taxonomy	Family Medicine Physician
NPI Enumerated	November 12, 2018

Payer Source	Total Paid
Medicaid	$546.8K
Medicare	$0

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

15 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…	3,350	$70	$231.1K
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…	4,040	$50	$214.3K
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…	580	$90	$53.9K
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…	290	$70	$20.6K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	350	$40	$13.2K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	90	$70	$6.3K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	120	$20	$2.6K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	60	$30	$1.6K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	610	$1	$1.2K
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,…	30	$40	$980

Showing 1–10 of 15

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

Bmh Inc — 0 of 15 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

15 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…	134	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…	110	620	560	$60	$191.8K
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…	30	140	100	$90	$54.4K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	35	50	210	$80	$51.4K
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…	69	220	90	$80	$51.4K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	31	40	150	$30	$30.8K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	168	180	140	$10	$28.4K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	12	30	80	$30	$25.5K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	25	70	190	$30	$16.7K
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,…	159	210	90	$20	$10.4K

Showing 1–10 of 15

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bmh Inc.	ID	Rural Health Clinic/Center	$0	$5.8M
Ananda Walaliyadda	ID	Specialist	$3.9M	$0
Bmh Inc	ID	Critical Access Hospital	$0	$3.5M
Bmh Inc	ID	Rural Health Clinic/Center	$0	$2.6M
Bmh, Inc.	ID	Surgery Physician	$0	$2.3M
Bmh, Inc.	ID	Family Medicine Physician	$0	$864.1K
Bmh, Inc.	ID	Sports Medicine (Family Medicine) Physician	$0	$765.1K
William Nibley	UT	Medical Oncology Physician	$166K	$326K
Bmh, Inc	ID	Family Medicine Physician	$0	$459.3K
Gregory Litton	UT	Medical Oncology Physician	$208.7K	$225.7K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bonneville School Dist #93	ID	Local Education Agency (LEA)	$0	$27.5M
Idaho Falls School District 91	ID	Local Education Agency (LEA)	$0	$11.2M
Affiliates Inc.	ID	Developmentally Disabled Services Day Training Agency	$0	$9.9M
Transitions, Inc.	ID	Developmentally Disabled Services Day Training Agency	$0	$7.8M
Innovative Health Care Concepts, Inc	ID	Case Manager/Care Coordinator	$0	$5.7M
Stewards Of Recovery	ID	Community/Behavioral Health Agency	$0	$5.1M
Joshua D. Smith Foundation	ID	Developmentally Disabled Services Day Training Agency	$0	$4.1M
See Opportunities And Achieve Results	ID	Case Management Agency	$0	$3.8M
Porter Eyecare PLLC	ID	Optometrist	$0	$3.1M
Denture Clinic Inc	ID	Dental Laboratory	$0	$3M

Bmh Inc — Billing Profile & Reimbursement Data

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Bmh Inc — 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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