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.

Sandpoint Family Medicine PA (NPI 1740493832)

Sandpoint Family Medicine PA is a family medicine physician provider located in Sandpoint, Idaho. This profile covers 0 Medicare and 25 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	Sandpoint Family Medicine PA
Address	302 S 1st Ave
City	Sandpoint
State	ID
ZIP	83864
Taxonomy	Family Medicine Physician
NPI Enumerated	May 7, 2007

Payer Source	Total Paid
Medicaid	$510.4K
Medicare	$0

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

25 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	4,330	$70	$311.8K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	400	$120	$49.3K
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…	780	$40	$34.4K
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…	260	$80	$21.2K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	1,120	$20	$20.1K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	400	$40	$15.7K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	290	$50	$15.4K
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	1,640	$10	$8.2K
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…	60	$130	$7.1K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	690	$10	$5.5K

Showing 1–10 of 25

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

Sandpoint Family Medicine PA — 0 of 23 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

25 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…	327	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…	81	620	560	$60	$191.8K
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…	12	10	160	$350	$103.6K
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…	95	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…	75	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…	96	180	70	$110	$45.6K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	2	10	120	$20	$37.9K
87631	The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,…	10	10	140	$120	$37.8K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	12	30	100	$50	$27.3K
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…	53	80	510	$10	$21.6K

Showing 1–10 of 25

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Boundary Regional Community Health Center, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$7M
Panhandle Special Needs, Inc.	ID	Developmentally Disabled Services Day Training Agency	$0	$4.6M
Idaho Pain Clinic PLLC	ID	Pain Medicine (Anesthesiology) Physician	$0	$2.2M
North Idaho Children's Mental Health, PLLC.	ID	Clinical Social Worker	$0	$2.2M
Bonner General Hospital Inc.	ID	Critical Access Hospital	$0	$1.6M
Boundary Regional Community Health Center, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$1.3M
Journey Pediatric Therapy	ID	Rehabilitation Clinic/Center	$0	$1.2M
Bonner County Ems	ID	Ambulance	$440.9K	$721.9K
Lake Pend Oreille School District #84	ID	Local Education Agency (LEA)	$0	$1M
Panhandle Support Services, LLC	ID	Case Management Agency	$0	$945.5K

Sandpoint Family Medicine PA — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mark Hernandez	ID	Family Medicine Physician	$138.5K	$0
Christina Rust	ID	Physician Assistant	$92.8K	$0
Hannah Raynor	ID	Family Medicine Physician	$90.1K	$0
Scott Dunn	ID	Family Medicine Physician	$82.1K	$0