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.

St. Mary's Hospital Inc (NPI 1174577100)

Field	Value
Entity Type	Organization
Organization	St. Mary's Hospital Inc
Address	701 Lewiston St
City	Cottonwood
State	ID
ZIP	83522
Taxonomy	Family Medicine Physician
NPI Enumerated	May 22, 2006

Payer Source	Total Paid
Medicaid	$581K
Medicare	$0

Medicaid: Complete Services Breakdown

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

16 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…	7,610	$40	$335K
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…	5,990	$40	$227.5K
99336	N/A	140	$50	$6.6K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	180	$20	$3.1K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	220	$10	$2.8K
0013A	N/A	40	$40	$1.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	10	$100	$1.4K
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	$10	$890
0011A	N/A	20	$40	$680
0012A	N/A	20	$40	$600

Showing 1–10 of 16

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

St. Mary's Hospital Inc — 1 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

16 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…	97	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…	51	620	560	$60	$191.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	51	60	50	$70	$35.5K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	82	180	140	$10	$28.4K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	73	80	510	$10	$21.6K
99336	N/A	11	20	210	$20	$14.5K
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,…	201	210	90	$20	$10.4K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	49	130	110	$10	$6.5K
0012A	N/A	25	40	30	$30	$3.4K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	64	100	260	$1	$2.8K

Showing 1–10 of 16

Related Providers

Other providers that share a Tax Identification Number (TIN) with St. Mary's Hospital Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Health System Corporation	WI	Multi-Specialty Clinic/Center	$0	$13.2M
Sheena Henry	ID	Rheumatology Physician	$466.6K	$0
Arlene Sussman	MN	Diagnostic Radiology Physician	$242.3K	$29.9K
Michael Grant	MN	Diagnostic Radiology Physician	$240.8K	$2.5K
Renata Kesala	MN	Diagnostic Radiology Physician	$226.6K	$0
Joseph Rozell	MN	Diagnostic Radiology Physician	$208K	$70
Eric Wallace	ID	Interventional Cardiology Physician	$191K	$0
David Moon	MN	Diagnostic Radiology Physician	$190.3K	$0
Robert Joodi	MN	Diagnostic Radiology Physician	$189.3K	$0
Allyson Stewart	TN	Psychiatric/Mental Health Nurse Practitioner	$171.6K	$0

St. Mary's Hospital Inc — Billing Profile & Reimbursement Data

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St. Mary's Hospital 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

Related Providers

Frequently Asked Questions

References