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 1225090954)

St. Joseph Hospital LLC is a general acute care hospital provider located in Lewiston, Idaho. This profile covers 0 Medicare and 152 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 St
City	Lewiston
State	ID
ZIP	83501
Taxonomy	General Acute Care Hospital
NPI Enumerated	April 6, 2006

Payer Source	Total Paid
Medicaid	$4.7M
Medicare	$0

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

152 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	9,650	$90	$839.1K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	22,830	$30	$776.2K
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.	6,320	$80	$492.8K
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…	6,950	$50	$340.5K
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.	4,070	$80	$309K
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.	1,880	$120	$225.8K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	3,060	$70	$205.3K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	3,500	$50	$157.5K
99281	The provider sees a patient for the lowest level emergency department visit.	1,560	$100	$155.8K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	1,710	$70	$121.6K

Showing 1–10 of 152

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 — 2 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

152 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.	14	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.	15	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.	144	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…	65	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.	11	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.	16	40	530	$70	$237.8K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	6	20	4,340	$10	$236.8K
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…	150	410	740	$60	$174.3K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	26	30	1,450	$50	$160K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	59	230	1,390	$40	$134.8K

Showing 1–10 of 152

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cancer Care Northwest Centers P S	WA	Hematology & Oncology Physician	$0	$3M
Danko Martincic	ID	Hematology & Oncology Physician	$2.6M	$0
Columbia Surgical Specialists, Ps	WA	Ambulatory Surgical Clinic/Center	$891.1K	$1.2M
Vijay Narendran	FL	Hematology & Oncology Physician	$2M	$0
Saritha Thumma	WA	Hematology & Oncology Physician	$1.8M	$0
Hakan Kaya	WA	Medical Oncology Physician	$1.8M	$0
Christopher Lee	WA	Radiation Oncology Physician	$1.7M	$0
Elizabeth Gunderson	WA	Medical Oncology Physician	$1.6M	$0
Srivalli Gopaluni	WA	Hematology & Oncology Physician	$1.6M	$0
Wayne Lamoreaux	WA	Radiation Oncology Physician	$1.5M	$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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