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.

5 Peppers Inc (NPI 1437504909)

Field	Value
Entity Type	Organization
Organization	5 Peppers Inc
Address	217 W. Georgia Ave. Ste 120
City	Nampa
State	ID
ZIP	83686
Taxonomy	Family Medicine Physician
NPI Enumerated	May 3, 2016

Payer Source	Total Paid
Medicaid	$441.6K
Medicare	$0

Medicaid: Complete Services Breakdown

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

9 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…	4,390	$80	$346.9K
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…	1,370	$40	$60.3K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	60	$130	$8.2K
99442	N/A	140	$50	$7.1K
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…	510	$10	$6.1K
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…	90	$60	$6K
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…	40	$140	$4.8K
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…	10	$100	$1.4K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	260	$1	$780

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

5 Peppers Inc — 0 of 9 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

9 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…	268	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…	78	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…	338	410	740	$60	$174.3K
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…	99	140	100	$90	$54.4K
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…	144	180	70	$110	$45.6K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	104	220	60	$100	$25.5K
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…	34	130	110	$10	$6.5K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	51	100	260	$1	$2.8K
99442	N/A	9	20	90	$10	$2.7K

Nearby Providers

Other providers in the same ZIP code as 5 Peppers Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
A&r Case Management	ID	Case Management Agency	$0	$18.1M
High Valley Developmental	ID	Developmentally Disabled Services Day Training Agency	$0	$15.5M
Nampa School District #131	ID	Local Education Agency (LEA)	$0	$15.2M
The Lilypad, LLC	ID	Developmentally Disabled Services Day Training Agency	$0	$8.3M
Witco, Inc.	ID	Developmentally Disabled Services Day Training Agency	$0	$8.3M
Allegiant Health LLC	ID	In Home Supportive Care Agency	$0	$6.9M
Vics Family Pharmacy Inc	ID	Pharmacy	$28.2K	$4.9M
Children's Dentistry Of Idaho, PLLC	ID	Pediatric Dentistry	$0	$3.9M
Idaho Dental Aid PLLC	ID	Dentist	$0	$3.6M
All For One, LLC	ID	Case Management Agency	$0	$2.5M

5 Peppers Inc — Billing Profile & Reimbursement Data

Sign up for 5 Peppers Inc — Billing Profile & Reimbursement Data policy alerts

5 Peppers Inc — Billing Profile & Reimbursement Data

Sign up for 5 Peppers Inc — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References