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.

Dirne Health Centers, Inc. (NPI 1285686477)

Key Findings

Field	Value
Entity Type	Organization
Organization	Dirne Health Centers, Inc.
Address	1090 W Park Place
City	Coeur D Alene
State	ID
ZIP	83814
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	May 16, 2006

Payer Source	Total Paid
Medicaid	$13.6M
Medicare	$0

This provider is effectively single-payer in the available data: there is no Medicare billing on file and all reported lifetime government revenue is Medicaid at $13.6M. The absence of Medicare activity means analyses of Medicare exposure, rate-setting, or competitive position at the national level are not applicable for this entity and Medicaid drives virtually the entire public-payer footprint.

Revenue is highly concentrated in a very small set of services: the precomputed top 3 Medicaid codes by revenue account for 94.8% of this provider's total Medicaid revenue, with a single code, T1015, representing $12.2M (89.7% of Medicaid revenue) across 85.9K claims at an average paid/claim of $142. This concentration indicates that the provider’s financial performance is heavily dependent on all-inclusive clinic encounter billing represented by T1015.

The provider’s FQHC taxonomy aligns with the dominant code mix: T1015 (clinic visit/encounter, all-inclusive) and G0467 (FQHC visit, established patient) together point to a high-volume, bundled community health center operating model, and G0511 activity indicates structured chronic care management or behavioral health integration services. G0511 activity (6.9K claims, $337.8K revenue, $49 avg paid/claim) being among the top revenue drivers suggests active care-management programs provided or directed by FQHC practitioners.

Competitive standing within Idaho is strong for FQHC-specific visit codes: T1015 ranks #4 of 143 providers in-state (98th percentile; notably above typical state volume for this code), while G0467 and G0511 each rank #1 in their peer groups (G0467: #1 of 32, 100th percentile, noted as an extreme outlier; G0511: #1 of 12, 100th percentile). These rankings indicate the center is a leading statewide provider of FQHC visits and clinic bundled encounters, especially compared with other Idaho FQHCs and rural clinics.

Beyond clinic bundles, the provider shows concentrated volume in post-acute and outreach services: several nursing-facility and home-visit codes appear prominently (for example, 99336: 4.9K claims, $83K revenue, rank #1 of 17, 100th percentile; 99307: 2.8K claims, $39.1K revenue, rank #1 of 15, 100th percentile), which signals substantial provision of nursing facility visits and on-site/residential care. This pattern suggests the organization’s operational footprint extends into long-term care settings and home/residence visit programs in addition to clinic-based care.

Ambulatory E/M activity is high in volume but low in per-claim reimbursement: 99214 (22.4K claims, $201.2K revenue, $9 avg paid/claim) and 99213 (30.5K claims, $122K revenue, $4 avg paid/claim) both rank in the top percentiles statewide (99214: 97th; 99213: 98th). This implies a high-throughput outpatient workload where visit counts are substantial contributors to access and service delivery metrics, while those codes individually represent a small share of total Medicaid dollars.

The provider exhibits a mixed profile of common primary-care supports and some specialized episodic services: routine lab and point-of-care codes (36415, 36416, 83036, 80053) and telehealth-related G2025 are present at typical or moderately high state percentiles, while certain diagnostic/drug-test codes (80305) and an infusion/injection code M0243 show notable placements (80305: rank #6 of 70, 93rd percentile; M0243: 48 claims, $13.1K revenue, rank #2 of 3). This combination reflects a broad primary care service set with occasional higher-cost or low-volume procedures.

The practice has long-standing administrative presence: the NPI was enumerated 2006-05-16 (~20 years ago), indicating multi-year establishment in the community. Coupled with the strong state rankings on FQHC visit and care-management codes, this tenure supports an interpretation of entrenched FQHC operations and established referral or patient panels within the region.

Medicaid: Complete Services Breakdown

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

82 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	85,910	$140	$12.2M
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	25,600	$10	$358.5K
G0511	Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral…	6,890	$50	$337.8K
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…	22,360	$10	$201.2K
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…	30,510	$1	$122K
99336	N/A	4,890	$20	$83K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	5,790	$10	$75.2K
99307	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making or the…	2,790	$10	$39.1K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	2,390	$10	$28.7K
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,…	5,370	$10	$26.8K

Showing 1–10 of 82

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

Dirne Health Centers, Inc. — 8 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

82 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	4	140	5,470	$180	$2.6M
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…	17	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…	17	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…	227	410	740	$60	$174.3K
96139	A technician administers two or more psychological or neuropsychological tests and scores them requiring an additional 30 minutes beyond the initial 30 minutes.	6	10	190	$270	$113.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	40	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.	34	80	460	$30	$77.7K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	5	30	790	$30	$68.4K
99349	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	5	20	580	$40	$53.7K
G0511	Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral…	1	10	370	$50	$53.4K

Showing 1–10 of 82

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Res-care Washington, Inc	ID	In Home Supportive Care Agency	$0	$31.9M
Coeur D'alene Pediatrics PA	ID	Pediatrics Physician	$0	$11.6M
Coeur D'alene School District #271	ID	Local Education Agency (LEA)	$0	$9.8M
Ambitions Of Idaho, Inc	ID	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$7.6M
Kootenai Health, Inc.	ID	General Acute Care Hospital	$0	$7M
Family Support Services Of North Idaho	ID	Mental Health Counselor	$0	$6.9M
Kootenai Health, Inc.	ID	Psychiatry Physician	$0	$6.7M
Collaborative Behavior Solutions, LLC	ID	Community/Behavioral Health Agency	$0	$5.9M
Kootenai County Emergency Medical Services System	ID	Land Ambulance	$1.7M	$3.6M
Inspired By You, LLC	ID	Developmental Disabilities Clinic/Center	$0	$4.8M

Dirne Health Centers, Inc. — Billing Profile & Reimbursement Data

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Dirne Health Centers, 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dirne Health Centers, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$7.1M
Dirne Health Centers, Inc	ID	Federally Qualified Health Center (FQHC)	$0	$6.7M
Dirne Health Centers, Inc	ID	Federally Qualified Health Center (FQHC)	$0	$6.5M
Dirne Health Centers, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$6.3M
Dirne Health Centers, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$3M
Dirne Health Centers Inc	ID	Federally Qualified Health Center (FQHC)	$0	$870.1K
Dirne Health Centers, Inc	ID	Federally Qualified Health Center (FQHC)	$0	$789.6K
Dirne Health Centers Inc	ID	Federally Qualified Health Center (FQHC)	$0	$390.1K
Kerri Ruddell	WA	Family Nurse Practitioner	$63.1K	$0
Jill White	ID	Psychiatric/Mental Health Nurse Practitioner	$28.8K	$0