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 Joseph Hospital LLC (NPI 1205368404)

St Joseph Hospital LLC is a internal medicine physician provider located in Lewiston, Idaho. This profile covers 0 Medicare and 62 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	St Joseph Hospital LLC
Address	415 6th Street
City	Lewiston
State	ID
ZIP	83501
Taxonomy	Internal Medicine Physician
NPI Enumerated	March 28, 2017

Payer Source	Total Paid
Medicaid	$1.1M
Medicare	$0

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

62 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…	9,630	$40	$394.7K
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…	7,450	$30	$193.7K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	3,460	$40	$134.9K
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…	830	$60	$52.2K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	2,240	$20	$49.4K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	1,580	$30	$47.3K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	350	$80	$28.3K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	250	$100	$25.8K
43248	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum; then through the scope, he passes a guidewire over which he passes dilators through the…	230	$100	$22.6K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	520	$30	$17.7K

Showing 1–10 of 62

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 Joseph Hospital LLC — 0 of 25 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

62 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	71	80	1,020	$90	$502.7K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	59	80	880	$70	$265.5K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	20	20	4,340	$10	$236.8K
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…	84	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…	40	620	560	$60	$191.8K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	98	410	740	$60	$174.3K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	14	20	200	$90	$158.3K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	38	60	1,370	$50	$151.3K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	5	10	20	$340	$94.9K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	45	50	560	$60	$82.3K

Showing 1–10 of 62

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Joseph Hospital LLC	ID	General Acute Care Hospital	$0	$4.7M
Robert Fairbanks	ID	Radiation Oncology Physician	$1.3M	$0
Norman Willis	ID	Radiation Oncology Physician	$573.4K	$0
Nileshkumar Patel	IL	Interventional Cardiology Physician	$415.3K	$132.8K
Edward Abraham	AR	Radiation Oncology Physician	$474.1K	$0
Edward Kim	ID	Cardiovascular Disease Physician	$299.4K	$0
Robert Leach	TX	Nephrology Physician	$277.7K	$0
John Ho	ID	Vascular & Interventional Radiology Physician	$239.9K	$0
John Jelinek	ID	Sports Medicine (Orthopaedic Surgery) Physician	$236.3K	$0
Melanie Eggleston	ID	Internal Medicine Physician	$234.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Alternative Nursing Services, Inc.	ID	Adult Day Care Clinic/Center	$0	$29.3M
Catalyst Medical Group, PLLC	ID	Multi-Specialty Clinic/Center	$0	$11.4M
Opportunities Unlimited, Inc.	ID	Specialist	$0	$9.1M
County Of Nez Perce Independent School District No 1	ID	Local Education Agency (LEA)	$0	$3.5M
Community Health Association Of Spokane	ID	Federally Qualified Health Center (FQHC)	$0	$3.2M
City Of Lewiston	ID	Land Ambulance	$697.3K	$1.9M
Riverside Recovery LLC	ID	Addiction (Substance Use Disorder) Counselor	$0	$2.1M
Addus Healthcare (idaho), Inc	ID	In Home Supportive Care Agency	$0	$2M
Emeritus Properties Ii, Inc.	ID	Assisted Living Facility	$0	$1.9M
Hospitalist Medicine Physicians Of Idaho- Nampa PLLC	ID	Emergency Medicine Physician	$0	$1.7M

St Joseph Hospital LLC — Billing Profile & Reimbursement Data

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St Joseph Hospital LLC — 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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