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.

Saint Alphonsus Medical Center Nampa, Inc. (NPI 1659371870)

Saint Alphonsus Medical Center Nampa, Inc. is a general acute care hospital provider located in Nampa, Idaho. This profile covers 0 Medicare and 194 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	Saint Alphonsus Medical Center Nampa, Inc.
Address	4300 E Flamingo Ave
City	Nampa
State	ID
ZIP	83687
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 29, 2005

Payer Source	Total Paid
Medicaid	$3.7M
Medicare	$0

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

194 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	620	$1,840	$1.1M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	2,670	$130	$339K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	2,750	$80	$231.3K
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.	21,030	$10	$126.2K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	22,110	$10	$110.5K
G0480	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…	1,400	$70	$103.5K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	2,200	$40	$94.7K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	2,710	$40	$94.7K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	2,210	$40	$90.7K
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.	1,360	$50	$65.1K

Showing 1–10 of 194

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

Saint Alphonsus Medical Center Nampa, Inc. — 3 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

194 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	7	20	500	$820	$662.5K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	19	60	1,080	$110	$595.5K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	30	80	1,020	$90	$502.7K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	31	80	880	$70	$265.5K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	10	40	530	$70	$237.8K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	9	20	4,340	$10	$236.8K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	32	30	1,450	$50	$160K
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…	144	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.	14	30	1,370	$50	$121.7K
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	8	10	160	$350	$103.6K

Showing 1–10 of 194

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Peacehealth	WA	General Acute Care Hospital	$0	$48.2M
Cep America LLC	IN	Emergency Medicine Physician	$0	$28.6M
Cep America, LLC	DC	Emergency Medicine Physician	$0	$15.6M
St Vincents Medical Center Inc	FL	General Acute Care Hospital	$0	$12.7M
Cep America LLC	MD	Emergency Medicine Physician	$0	$12M
Cep America, LLC	VA	Emergency Medicine Physician	$0	$9.7M
Cep America LLC	IN	Emergency Medicine Physician	$0	$9M
Cep America LLC	IN	Emergency Medicine Physician	$0	$6.9M
Cep America LLC	OR	Emergency Medicine Physician	$0	$5.7M
Cep America LLC	WA	Emergency Medicine Physician	$0	$5.5M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Health Clinics, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$37.7M
Rescare Washington Inc	ID	Nursing Care Agency	$0	$8.2M
Assisting Hands Home Care - Boise, LLC	ID	Home Health Agency	$0	$7.6M
Idaho Pediatric Dentistry	ID	Pediatric Dentistry	$0	$4.9M
Unbefuddled, LLC	ID	Case Management Agency	$0	$4.6M
Best Homecare And Staffing LLC	ID	Home Health Agency	$0	$2.6M
Advanced Services LLC	ID	Developmentally Disabled Services Day Training Agency	$0	$2.6M
Norco, Inc.	ID	Oxygen Equipment & Supplies (DME)	$0	$2.4M
St Lukes West Ltd	ID	General Acute Care Hospital	$0	$1.9M
Unity Service Coordination	ID	Case Management Agency	$0	$1.6M

Saint Alphonsus Medical Center Nampa, Inc. — Billing Profile & Reimbursement Data

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Saint Alphonsus Medical Center Nampa, Inc. — 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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