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- Ontario Inc (NPI 1760823397)

Saint Alphonsus Medical Center- Ontario Inc is a rural health clinic/center provider located in Fruitland, Idaho. This profile covers 0 Medicare and 16 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- Ontario Inc
Address	910 Nw 16th St
City	Fruitland
State	ID
ZIP	83619
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	July 11, 2013

Payer Source	Total Paid
Medicaid	$854.6K
Medicare	$0

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	7,740	$100	$735.1K
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…	4,770	$20	$81.1K
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…	2,690	$10	$29.6K
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…	20	$130	$3K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	60	$50	$2.9K
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…	210	$10	$1.7K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	40	$20	$700
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…	30	$10	$250
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	140	$1	$140
J3301	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	10	$10	$90

Showing 1–10 of 16

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- Ontario Inc — 0 of 11 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

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	60	140	5,470	$180	$2.6M
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…	116	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…	135	620	560	$60	$191.8K
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…	86	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…	134	180	70	$110	$45.6K
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…	24	30	100	$50	$27.3K
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,…	47	60	140	$30	$16.1K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	46	80	60	$50	$15.1K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	65	80	120	$10	$9.1K
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	19	40	180	$10	$7.1K

Showing 1–10 of 16

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saint Alphonsus Regional Medical Center Inc	ID	General Acute Care Hospital	$0	$5.1M
Saint Alphonsus Regional Medical Center Inc	ID	General Acute Care Hospital	$0	$4.2M
Saint Alphonsus Medical Center- Ontario Inc	OR	General Acute Care Hospital	$0	$3.7M
Adam Grimaldi	ID	Clinical Cardiac Electrophysiology Physician	$247.1K	$0
John Foote	ID	Orthopaedic Surgery Physician	$140.1K	$0
Michael Rich	ID	Cardiovascular Disease Physician	$125K	$0
Paul Gering	OR	Family Medicine Physician	$105.1K	$0
NPI 1548408669	—	—	$82.2K	$0
Eli Harris	ID	Pain Medicine (Anesthesiology) Physician	$62.2K	$0
Jason Quinn	ID	Emergency Medicine Physician	$46.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Snake River Pediatrics, PC	ID	Pediatrics Physician	$0	$5.3M
Snake River Pediatrics, PC	ID	Rural Health Clinic/Center	$0	$3.2M
Edgewood Fruitland Senior Living LLC	ID	Assisted Living Facility	$0	$2.5M
Current Physical Therapy LLC	ID	Physical Therapist	$0	$1.8M
City Of Fruitland	ID	Ambulance	$414.3K	$1.2M
Ryan Hillam	ID	Dentist	$0	$397.4K
Brock Andersen	ID	Dermatology Physician	$265.9K	$0
Nicholas Hartley	ID	Physical Therapist	$103.4K	$0
Dallin Wilkes	ID	Physical Therapist	$97.4K	$0
Jeanna Rendo	ID	Nurse Practitioner	$76.6K	$0

Saint Alphonsus Medical Center- Ontario Inc — Billing Profile & Reimbursement Data

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Saint Alphonsus Medical Center- Ontario 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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