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.

Eastern Idaho Health Services Inc (NPI 1225082209)

Key Findings

Field	Value
Entity Type	Organization
Organization	Eastern Idaho Health Services Inc
Address	3100 Channing Way
City	Idaho Falls
State	ID
ZIP	83404
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 22, 2006

Payer Source	Total Paid
Medicaid	$12.1M
Medicare	$0

This provider operates effectively as a Medicaid-focused hospital: there is no Medicare billing on file and Total Medicaid revenue is $12.1M, so payor exposure is concentrated in state Medicaid rather than a dual Medicare/Medicaid mix. That single-payer orientation increases sensitivity to Medicaid rate and policy changes because Medicare revenue streams are absent.

Revenue is highly concentrated in a few emergency department evaluation-and-management codes: the precomputed top three Medicaid codes account for 67.9% of the provider's total Medicaid revenue, driven by 99284 ($3.7M, 34.3%), 99283 ($3M, 28.1%), and 99285 ($592.8K, 5.5%). This concentration indicates the hospital’s financial profile depends heavily on ED visit volumes rather than a broad mix of inpatient DRGs or elective procedures.

Operational footprint appears to be emergency-department centric with high ambulatory throughput: 99284 shows 17.8K claims at $207 avg paid/claim generating $3.7M (34.3% of Medicaid revenue), and 99283 shows 18K claims at $168 avg paid/claim generating $3M (28.1%). Those volumes are consistent with a busy ED handling large numbers of low- to moderate-acuity visits and suggest capacity and staffing geared toward urgent care and ED services.

Competitive standing within the state is strong for lower-acuity ED visits but more modest for the highest-acuity ED care: 99283 ranks #3 of 83 providers in-state (98th percentile; notably above typical state volume for this code), while 99284 ranks #7 of 75 (92th percentile; typical, unremarkable), and 99285 ranks #21 of 57 (64th percentile; typical, unremarkable). In plain terms, the provider is a leading destination for straightforward ED encounters but not among the very top centers for the most complex ED decision-making.

The provider is an outlier in medication administration and infusion activity, indicating substantial IV/clinic infusion throughput: 96374 reports 14.5K claims and $334K revenue (3.1% of Medicaid revenue) and ranks #1 of 29 providers in-state (100th percentile; extreme outlier), while 96375 (6.6K claims, $211.9K, 2.0%) also ranks #1 of 26 (100th percentile; notably above typical state volume) and 96365 ranks #3 of 24 providers (91th percentile; notably above typical). These patterns point to a high-volume site for IV injections, pushes, and sequential infusions consistent with ED, observation, or outpatient infusion services.

Laboratory and basic diagnostic throughput is also elevated and concentrated in a few tests: 85027 (CBC) shows 25.2K claims and $100.9K revenue and ranks #1 of 33 providers in-state (100th percentile; extreme outlier), 87633 and 87631 (multiplex respiratory NAATs) are high in both revenue and rank (87633: $391.2K, rank #2 of 13, 92th percentile; 87631: $145.4K, rank #2 of 11, 90th percentile), and 87798 ranks #1 of 17 (100th percentile; extreme outlier). Together these data indicate substantial on-site lab testing volume supporting ED and acute respiratory diagnostics.

The network and code mix create concentration risk: with the top three codes responsible for 67.9% of Medicaid revenue and no Medicare billing reported, the provider’s financial performance is tightly linked to ED visit volumes and Medicaid reimbursement for those specific codes. Any shifts in Medicaid utilization patterns, authorization rules, or reimbursement for ED E/M services could materially affect overall revenue given this concentration.

The provider shows longevity in the market, with its NPI enumerated 2006-05-22 (~20 years ago), and the combination of long tenure plus extreme-outlier volumes on multiple procedural and lab codes (e.g., 96374, 96375, 85027, 87798 all at 100th percentile labels) supports the conclusion that this is an established regional facility with persistent high-volume ED, infusion, and lab operations rather than a short-lived or low-throughput clinic.

Medicaid: Complete Services Breakdown

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

223 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	17,800	$210	$3.7M
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.	17,980	$170	$3M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	2,030	$290	$592.8K
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	1,060	$370	$391.2K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	14,520	$20	$334K
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.	4,150	$80	$331.8K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	2,250	$110	$257K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	7,940	$30	$222.4K
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	6,620	$30	$211.9K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	3,260	$60	$195.7K

Showing 1–10 of 223

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

Eastern Idaho Health Services Inc — 7 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

223 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	21	60	1,080	$110	$595.5K
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.	7	80	1,020	$90	$502.7K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	98	280	1,480	$70	$389.4K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	103	210	3,020	$50	$389K
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.	3	80	880	$70	$265.5K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	12	40	530	$70	$237.8K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	12	20	4,340	$10	$236.8K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	10	20	110	$840	$224.4K
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…	392	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…	400	620	560	$60	$191.8K

Showing 1–10 of 223

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Douglas Blank	ID	Cardiovascular Disease Physician	$183.3K	$0
Brent Greenwald	ID	Neurological Surgery Physician	$59.7K	$0
Matthew Griggs	ID	Emergency Medical Services (Emergency Medicine) Physician	$59.5K	$0
Scott Cross	ID	Undersea and Hyperbaric Medicine (Emergency Medicine) Physician	$59.5K	$0
Justin Thompson	ID	Emergency Medicine Physician	$58.7K	$0
Robert Yapundich	UT	Neurology Physician	$55.4K	$0
Jeffrey Rosenberg	WY	Emergency Medicine Physician	$39K	$0
Ivy Hansen	ID	Medical Physician Assistant	$11.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mountain View Hospital LLC	ID	General Acute Care Hospital	$0	$45.7M
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
Kyle Thompson	ID	Retina Specialist (Ophthalmology) Physician	$4.5M	$0

Eastern Idaho Health Services Inc — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References