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 1215511241)

Bmh, Inc. is a family medicine physician provider located in Pocatello, Idaho. This profile covers 0 Medicare and 18 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	850 Yellowstone Ave Ste B
City	Pocatello
State	ID
ZIP	83201
Taxonomy	Family Medicine Physician
NPI Enumerated	May 6, 2021

Payer Source	Total Paid
Medicaid	$864.1K
Medicare	$0

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

18 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…	5,710	$90	$507.8K
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…	3,530	$60	$225.7K
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…	510	$80	$40.4K
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…	200	$140	$27.7K
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…	250	$80	$19.1K
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…	330	$40	$13.6K
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.	290	$30	$8.1K
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…	720	$10	$6.5K
95886	The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more…	90	$60	$5.2K
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…	40	$120	$4.7K

Showing 1–10 of 18

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 17 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

18 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…	157	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…	63	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…	56	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…	21	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…	51	220	90	$80	$51.4K
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…	111	180	70	$110	$45.6K
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.	18	40	150	$30	$30.8K
99205	The provider sees a new 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 provider…	38	50	50	$150	$29.2K
95886	The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more…	10	10	120	$90	$22.2K
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…	26	70	190	$30	$16.7K

Showing 1–10 of 18

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	Sports Medicine (Family Medicine) Physician	$0	$765.1K
Bmh Inc	ID	Family Medicine Physician	$0	$546.8K
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
Moonlight Mountain Recovery, Inc	ID	Substance Abuse Rehabilitation Facility	$0	$17.7M
Pocatello Children & Adolescent Clinic	ID	Pediatrics Physician	$0	$11M
Speech Therapy Services, LLC	ID	Speech-Language Pathologist	$0	$8.5M
Pocatello Chubbuck School District #25	ID	Local Education Agency (LEA)	$0	$7.9M
Facial & Oral Surgery Associates, Inc.	ID	Oral and Maxillofacial Surgery (Dentist)	$0	$6.3M
Health West, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$6.2M
Pocatello Hospital LLC	ID	General Acute Care Hospital	$0	$6.1M
Health West, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$5.9M
Rocky Mountain Physician Group LLC	ID	Emergency Medicine Physician	$0	$5.5M
Community Mental Health	ID	Community/Behavioral Health Agency	$0	$4.3M

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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