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.

Stephen Smith (NPI 1639448798)

Field	Value
Entity Type	Individual
Organization	Stephen Smith
Address	611 Clinic Road
City	Challis
State	ID
ZIP	83226
Taxonomy	Physician Assistant
NPI Enumerated	December 19, 2011

Payer Source	Total Paid
Medicare	$1.9K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	30	$40	$1K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	20	$20	$290
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	20	$10	$180
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	10	$10	$140
81002	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dip stick, and shakes off the excess urine. Alternatively, the analyst may place drops of the urine specimen…	50	$1	$140
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	30	$1	$100

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Idaho Distribution

Stephen Smith — 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. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
80053	106	120	100	$10	$3K
71046	192	230	50	$10	$1K
87811	22	70	20	$40	$910
87804	6	10	30	$20	$700
93005	10	30	20	$1	$120
81002	25	200	20	$1	$100

Related Providers

Other providers that share a Tax Identification Number (TIN) with Stephen Smith, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Challis Area Health Center Incorporated	ID	Federally Qualified Health Center (FQHC)	$0	$2.5M
Miles Haeberle	ID	Physician Assistant	$1.3K	$0
Matthew Banks	ID	Physician Assistant	$680	$0

Nearby Providers

Other providers in the same ZIP code as Stephen Smith, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Thomas Fife	ID	Medical Physician Assistant	$1.4K	$0

Stephen Smith — Billing Profile & Reimbursement Data

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Stephen Smith — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References