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.

Primary Care Specialists, PA (NPI 1508875881)

Field	Value
Entity Type	Organization
Organization	Primary Care Specialists, PA
Address	110 Vista Drive
City	Pocatello
State	ID
ZIP	83201
Taxonomy	Primary Care Clinic/Center
NPI Enumerated	August 5, 2006

Payer Source	Total Paid
Medicaid	$344.5K
Medicare	$0

Medicaid: Complete Services Breakdown

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

6 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…	2,920	$90	$248.3K
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…	1,490	$60	$93.6K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	40	$50	$2K
90688	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It uses split virus technology and is given as a 0.5 mL dose.	20	$20	$270
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	20	$10	$180
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	10	$10	$70

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

Primary Care Specialists, PA — 0 of 6 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

6 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…	256	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…	129	620	560	$60	$191.8K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	158	180	140	$10	$28.4K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	19	30	100	$50	$27.3K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	206	210	510	$1	$7K
90688	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It uses split virus technology and is given as a 0.5 mL dose.	34	50	30	$1	$210

Related Providers

Other providers that share a Tax Identification Number (TIN) with Primary Care Specialists, PA, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mark Mansfield	ID	Family Medicine Physician	$134.6K	$0
Richard Maynard	ID	Family Medicine Physician	$101.4K	$0
Jacob Shirley	CO	Physician Assistant	$41K	$0

Nearby Providers

Other providers in the same ZIP code as Primary Care Specialists, PA, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Moonlight Mountain Recovery, Inc	ID	Substance Abuse Rehabilitation Facility	$0	$17.7M
Pocatello Children & Adolescent Clinic	ID	Pediatrics Physician	$0	$11M
Speech Therapy Services, LLC	ID	Speech-Language Pathologist	$0	$8.5M
Pocatello Chubbuck School District #25	ID	Local Education Agency (LEA)	$0	$7.9M
Facial & Oral Surgery Associates, Inc.	ID	Oral and Maxillofacial Surgery (Dentist)	$0	$6.3M
Health West, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$6.2M
Pocatello Hospital LLC	ID	General Acute Care Hospital	$0	$6.1M
Health West, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$5.9M
Rocky Mountain Physician Group LLC	ID	Emergency Medicine Physician	$0	$5.5M
Community Mental Health	ID	Community/Behavioral Health Agency	$0	$4.3M

Primary Care Specialists, PA — Billing Profile & Reimbursement Data

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Primary Care Specialists, PA — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References