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.

North Idaho Eye Institute P A (NPI 1699811646)

Field	Value
Entity Type	Organization
Organization	North Idaho Eye Institute P A
Address	1814 Lincoln Way
City	Coeur D Alene
State	ID
ZIP	83814
Taxonomy	Ophthalmology Physician
NPI Enumerated	January 29, 2007

Payer Source	Total Paid
Medicaid	$644K
Medicare	$0

Medicaid: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	4,000	$70	$295.6K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	2,620	$100	$261.7K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	1,030	$40	$38.3K
92134	The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.	2,690	$10	$32.3K
92015	The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced.	9,180	$1	$9.2K
92012	For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…	150	$50	$6.9K
1036F	N/A	340	$0	$0
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	400	$0	$0
G8428	Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given	40	$0	$0
G8785	Blood pressure reading not documented, reason not given	560	$0	$0

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

North Idaho Eye Institute P A — 2 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

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	9	160	320	$90	$92.8K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	5	10	990	$50	$87.9K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	6	130	120	$110	$50.2K
92134	The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.	4	20	690	$20	$29.7K
92012	For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…	4	10	80	$50	$9.8K
92015	The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced.	3	120	350	$1	$1.9K
G8785	Blood pressure reading not documented, reason not given	2	10	560	$1	$30
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	19	40	420	$1	$20
G8428	Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given	4	10	190	$1	$20
1036F	N/A	23	40	440	$1	$10

Related Providers

Other providers that share a Tax Identification Number (TIN) with North Idaho Eye Institute P A, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Golden Buckland	ID	Ophthalmology Physician	$1.2M	$0
Alison Granier	ID	Ophthalmology Physician	$842.5K	$0
Drew Thomas	ID	Ophthalmology Physician	$774.2K	$0
David Dance	ID	Ophthalmology Physician	$711.8K	$0
Sara Duke	ID	Ophthalmology Physician	$611.7K	$0
Whitney Myers	ID	Ophthalmology Physician	$412.8K	$0
John Calderwood	ID	Optometrist	$97.4K	$0
Katherine Gleason	ID	Optometrist	$47.4K	$0
John Weisel	ID	Optometrist	$44.8K	$0

Nearby Providers

Other providers in the same ZIP code as North Idaho Eye Institute P A, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Res-care Washington, Inc	ID	In Home Supportive Care Agency	$0	$31.9M
Dirne Health Centers, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$13.6M
Coeur D'alene Pediatrics PA	ID	Pediatrics Physician	$0	$11.6M
Coeur D'alene School District #271	ID	Local Education Agency (LEA)	$0	$9.8M
Ambitions Of Idaho, Inc	ID	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$7.6M
Dirne Health Centers, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$7.1M
Kootenai Health, Inc.	ID	General Acute Care Hospital	$0	$7M
Family Support Services Of North Idaho	ID	Mental Health Counselor	$0	$6.9M
Dirne Health Centers, Inc	ID	Federally Qualified Health Center (FQHC)	$0	$6.7M
Kootenai Health, Inc.	ID	Psychiatry Physician	$0	$6.7M

North Idaho Eye Institute P A — Billing Profile & Reimbursement Data

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North Idaho Eye Institute 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

Related Providers

Nearby Providers

Frequently Asked Questions

References