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.

St Lukes Regional Medical Center (NPI 1699013565)

St Lukes Regional Medical Center is a critical access hospital provider located in Mountain Home, Idaho. This profile covers 0 Medicare and 108 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	St Lukes Regional Medical Center
Address	895 N 6th E
City	Mountain Home
State	ID
ZIP	83647
Taxonomy	Critical Access Hospital
NPI Enumerated	January 28, 2013

Payer Source	Total Paid
Medicaid	$940.7K
Medicare	$0

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

108 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	1,310	$110	$149.5K
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.	580	$170	$95.9K
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.	1,100	$90	$93.8K
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.	7,010	$10	$56.1K
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…	8,740	$10	$52.4K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	740	$50	$34.7K
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…	420	$80	$32.1K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	510	$40	$21.5K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	560	$40	$20.1K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	560	$40	$20.1K

Showing 1–10 of 108

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

St Lukes Regional Medical Center — 0 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

108 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	44	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.	36	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.	39	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.	21	40	530	$70	$237.8K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	14	20	4,340	$10	$236.8K
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…	396	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…	357	620	560	$60	$191.8K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	15	20	270	$60	$101K
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…	13	20	1,060	$70	$84.3K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	30	50	560	$60	$82.3K

Showing 1–10 of 108

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Lukes Regional Medical Center	ID	General Acute Care Hospital	$0	$25.1M
St Lukes Clinic-treasure Valley LLC	ID	Family Medicine Physician	$0	$6.9M
St Lukes Clinic-treasure Valley LLC	OR	Rural Health Clinic/Center	$0	$2.1M
St Luke's Regional Medical Center	ID	Home Health Agency	$0	$1.6M
Peter Castellanos	ID	Neurology with Special Qualifications in Child Neurology Physician	$0	$599.5K
St Luke's Regional Medical Center	ID	Community Based Hospice Care Agency	$0	$397.2K
Marcos Daccarett	ID	Clinical Cardiac Electrophysiology Physician	$202.3K	$0
Steven Newman	UT	Family Medicine Physician	$177.3K	$13.9K
Tonya Kuhn	ID	Radiation Oncology Physician	$187.9K	$0
Ronald Kristensen	ID	Orthopaedic Surgery Physician	$158.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Advanced Therapy Care PLLC	ID	Hearing and Speech Clinic/Center	$0	$5.5M
Sequel Tsi Of Idaho, LLC	ID	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$3.7M
Glenns Ferry Health Center, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$3.3M
Playhouse Dentistry For Kids	ID	Pediatric Dentistry	$0	$1.6M
County Of Elmore	ID	Land Ambulance	$246.9K	$634.2K
Mountain Home School District 193	ID	Local Education Agency (LEA)	$0	$611.8K
Scott Baldridge	ID	Sleep Medicine (Family Medicine) Physician	$86K	$0
Timothy Muhonen	ID	Family Medicine Physician	$85.3K	$0
Anson Call	ID	Physical Therapist	$55.1K	$0
Charlene Clark	ID	Family Nurse Practitioner	$25K	$0

St Lukes Regional Medical Center — Billing Profile & Reimbursement Data

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St Lukes Regional Medical Center — 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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