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.

Simpson Dermcare And Family Medicine PLLC (NPI 1174919534)

Simpson Dermcare And Family Medicine PLLC is a family medicine physician provider located in Idaho Falls, Idaho. This profile covers 0 Medicare and 31 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	Simpson Dermcare And Family Medicine PLLC
Address	2225 Teton Plz
City	Idaho Falls
State	ID
ZIP	83404
Taxonomy	Family Medicine Physician
NPI Enumerated	April 13, 2015

Payer Source	Total Paid
Medicaid	$1.8M
Medicare	$0

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

31 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…	13,080	$60	$771.7K
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…	3,390	$90	$291.5K
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…	2,710	$90	$230.7K
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…	2,160	$90	$202.6K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	4,350	$40	$182.7K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	2,300	$40	$101K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	300	$90	$26.1K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	170	$90	$15K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	20	$80	$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,…	50	$40	$1.9K

Showing 1–10 of 31

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

Simpson Dermcare And Family Medicine PLLC — 0 of 18 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

31 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…	44	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…	133	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…	21	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…	16	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.	28	80	130	$80	$91.4K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	9	80	460	$30	$77.7K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	9	60	290	$30	$48.7K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	128	180	140	$10	$28.4K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	40	50	170	$50	$19K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	16	20	90	$80	$15.9K

Showing 1–10 of 31

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

Simpson Dermcare And Family Medicine PLLC — Billing Profile & Reimbursement Data

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Simpson Dermcare And Family Medicine 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

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