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.

Idaho Pain Clinic PLLC (NPI 1417267329)

Idaho Pain Clinic PLLC is a pain medicine (anesthesiology) physician provider located in Sandpoint, Idaho. This profile covers 0 Medicare and 22 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	Idaho Pain Clinic PLLC
Address	1327 Superior St Ste 101
City	Sandpoint
State	ID
ZIP	83864
Taxonomy	Pain Medicine (Anesthesiology) Physician
NPI Enumerated	October 13, 2010

Payer Source	Total Paid
Medicaid	$2.2M
Medicare	$0

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

22 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…	29,460	$50	$1.6M
G0482	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	2,220	$120	$255.3K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	4,060	$50	$191K
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…	930	$80	$70.5K
G0481	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	240	$130	$31.4K
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…	780	$40	$31.1K
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…	540	$40	$21.7K
64493	The provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging guidance…	180	$110	$20.1K
62323	The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the lumbar (lower back) or sacral (caudal, or tailbone)…	170	$110	$18.2K
64483	This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral).	50	$150	$7.9K

Showing 1–10 of 22

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

Idaho Pain Clinic PLLC — 1 of 21 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

22 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…	380	670	740	$40	$193.6K
G0482	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	2	10	850	$130	$192.1K
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…	11	620	560	$60	$191.8K
G0481	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	6	10	440	$110	$188.4K
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…	147	230	1,390	$40	$134.8K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	4	30	1,370	$50	$121.7K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	125	140	710	$20	$76.4K
64493	The provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging guidance…	2	10	50	$360	$57.4K
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…	16	180	70	$110	$45.6K
64494	In this add–on procedure, the provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that…	2	10	80	$150	$36.2K

Showing 1–10 of 22

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jeffrey Ispirescu	ID	Pain Medicine (Anesthesiology) Physician	$197.5K	$0
Clinton Thome	ID	Pain Medicine (Anesthesiology) Physician	$130.8K	$0
Sarah Rains	ID	Physician Assistant	$117.8K	$0
Leslie Rogers	ID	Family Nurse Practitioner	$117.7K	$0
Matthew Hansen	ID	Physician Assistant	$110.8K	$0
Amber Farance	ID	Physician Assistant	$105.8K	$0
Jonathan Lippman	ID	Physician Assistant	$73K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Boundary Regional Community Health Center, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$7M
Panhandle Special Needs, Inc.	ID	Developmentally Disabled Services Day Training Agency	$0	$4.6M
North Idaho Children's Mental Health, PLLC.	ID	Clinical Social Worker	$0	$2.2M
Bonner General Hospital Inc.	ID	Critical Access Hospital	$0	$1.6M
Boundary Regional Community Health Center, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$1.3M
Journey Pediatric Therapy	ID	Rehabilitation Clinic/Center	$0	$1.2M
Bonner County Ems	ID	Ambulance	$440.9K	$721.9K
Lake Pend Oreille School District #84	ID	Local Education Agency (LEA)	$0	$1M
Panhandle Support Services, LLC	ID	Case Management Agency	$0	$945.5K
Advanced Care Northwest LLC	ID	Non-emergency Medical Transport (VAN)	$0	$739.5K

Idaho Pain Clinic PLLC — Billing Profile & Reimbursement Data

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Idaho Pain Clinic PLLC — 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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