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.

Spine Institute Of Idaho P A (NPI 1659380269)

Spine Institute Of Idaho P A is a orthopaedic surgery of the spine physician provider located in Meridian, Idaho. This profile covers 0 Medicare and 15 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	Spine Institute Of Idaho P A
Address	360 E Montvue Dr
City	Meridian
State	ID
ZIP	83642
Taxonomy	Orthopaedic Surgery of the Spine Physician
NPI Enumerated	August 5, 2006

Payer Source	Total Paid
Medicaid	$549.3K
Medicare	$0

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	5,310	$50	$244.2K
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…	3,030	$70	$197.1K
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).	470	$170	$77.5K
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…	120	$100	$12.1K
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…	30	$150	$4.5K
62321	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 cervical (neck) or thoracic (upper and middle back)…	30	$150	$3.6K
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…	70	$50	$3.3K
72110	In this diagnostic procedure, the provider performs at least four X–ray views of the lumbosacral spine to evaluate the patient's spine for the presence of abnormal curves, fractures, or cancer.	60	$30	$1.9K
J1100	Injection, dexamethasone sodium phosphate, 1 mg	1,200	$1	$1.2K
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…	10	$90	$1.1K

Showing 1–10 of 15

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

Spine Institute Of Idaho P A — 0 of 14 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

15 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…	104	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…	122	620	560	$60	$191.8K
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…	215	230	1,390	$40	$134.8K
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…	4	10	50	$360	$57.4K
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…	138	140	100	$90	$54.4K
99203	The provider sees a new 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 provider…	199	220	90	$80	$51.4K
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…	64	180	70	$110	$45.6K
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).	2	10	30	$240	$26.4K
95886	The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more…	14	10	120	$90	$22.2K
62321	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 cervical (neck) or thoracic (upper and middle back)…	3	10	30	$200	$8K

Showing 1–10 of 15

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Michael Spackman	ID	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$83.9K	$0
Warren Dopson	ID	Internal Medicine Physician	$70.3K	$2.1K
Shannon Gardiner	ID	Surgical Physician Assistant	$40K	$0
Samuel Jorgenson	ID	Orthopaedic Surgery of the Spine Physician	$35.6K	$0
Beth Rogers	ID	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$32K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Norco, Inc.	ID	Durable Medical Equipment & Medical Supplies	$0	$41M
Joint School District No. 2	ID	Local Education Agency (LEA)	$0	$34.2M
Chatterbox Speech & Language Center	ID	Speech-Language Pathologist	$0	$10.6M
St. Fillan's, LLC	ID	In Home Supportive Care Agency	$0	$10.5M
Southern Idaho Health Partners LLC	ID	General Practice Physician	$0	$9.2M
Gem State Developmental Center LLC	ID	Developmentally Disabled Services Day Training Agency	$0	$9.1M
Addus Healthcare, Inc.	ID	In Home Supportive Care Agency	$0	$6.1M
Northwest Neurobehavioral Health, LLC	ID	Clinical Social Worker	$0	$5.2M
Idaho Pediatric Therapy Clinic PLLC	ID	Physical Therapist	$0	$3.1M
Cpapnow Inc	ID	Durable Medical Equipment & Medical Supplies	$0	$3.1M

Spine Institute Of Idaho P A — Billing Profile & Reimbursement Data

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Spine Institute Of Idaho P A — 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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