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.

Derek Hamblin (NPI 1790713204)

Field	Value
Entity Type	Individual
Organization	Derek Hamblin
Address	4815 Cleveland Blvd
City	Caldwell
State	ID
ZIP	83605
Taxonomy	Family Medicine Physician
NPI Enumerated	June 30, 2006

Payer Source	Total Paid
Medicare	$390.9K
Medicaid	$0

Key Findings

Practice profile and service mix: Medicare billing is overwhelmingly driven by vaccine product and vaccine-administration codes, with 91320, 90694, and 90480 appearing as the top billers. 91320 accounted for $154.2K revenue (39.4% of Medicare revenue) from 1.2K claims, 90694 accounted for $106.7K (27.3%) from 1.4K claims, and 90480 accounted for $47K (12.0%) from 1.2K claims, indicating that immunization delivery (COVID and seasonal influenza) is the core operational activity reflected in Medicare claims.

Revenue concentration and financial exposure: the provider’s top three Medicare codes account for 78.7% of total Medicare revenue, and total Medicare revenue is $390.9K. This degree of concentration on a small set of vaccine and vaccine-administration codes implies material dependence on immunization services for overall Medicare receipts, which could make revenue sensitive to changes in vaccine demand or reimbursement.

Payer mix and market footprint: this provider reports $390.9K in Medicare revenue and no Medicaid billing on file, making the practice effectively single-payer (Medicare) in the available data. Absence of Medicaid billing suggests limited or no participation in state Medicaid programs and means analysts should treat in-state Medicaid market share as negligible or unobserved for contracting and network planning purposes.

Competitive standing on vaccine delivery: the provider ranks among highly ranked peers nationally on key vaccine lines — 90694 ranks #35 of 51679 providers nationally (100th percentile; notably above typical national volume), and 91320 ranks #39 of 27083 providers nationally (100th percentile; typical, unremarkable volume). These rank positions indicate the provider is a high-volume administrator of influenza and COVID vaccine products relative to most national peers, with 90694 specifically flagged as above typical volume.

Low evaluation-and-management (E/M) billing relative to preventive care: traditional office visit codes are a small share of Medicare revenue, with 99213 reporting $2.9K (0.7%) and 99214 reporting $1.3K (0.3%) of Medicare revenue. 99213 ranks #276163 of 457151 (39th percentile; typical, unremarkable volume) while 99214 ranks #461489 of 479517 (3th percentile; typical, unremarkable volume), which together suggest limited billed chronic or complex outpatient management through Medicare compared with the provider’s preventive-immunization focus.

Notable unnamed administration codes and other vaccine-support codes: several HCPCS entries with no public description (0124A, 0134A, 0121A) appear in the top-25 and materially contribute to vaccine-related revenue — 0124A shows 409 claims and $16K revenue (4.1%), 0134A shows 167 claims and $6.5K (1.7%), and 0121A shows 48 claims and $1.9K (0.5%) and ranks #26 of 713 providers nationally (96th percentile; notably above typical national volume). These unnamed codes likely represent program- or product-specific administration items that supplement the practice’s immunization throughput.

Tenure and continuity: the provider’s NPI was enumerated on 2006-06-30 (~20 years ago), indicating a long-standing presence in the claims record. That tenure supports interpreting the observed vaccine-centered billing pattern as an established business orientation rather than a short-term or anomalous spike.

Ancillary services are minimal in Medicare billing: non-vaccine ancillary items such as SARS–CoV–2 immunoassay 87811 ($738), chest radiograph 71046 ($264), and routine blood draw 36415 ($168) appear only at very low revenue levels. This further reinforces that the Medicare footprint is concentrated on vaccine delivery rather than broader diagnostic or procedural services.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
91320	This code represents a SARS–CoV–2 vaccine product (tris–sucrose formulation) administered by intramuscular injection to reduce the patient’s risk of contracting COVID–19. The dosage is 30 mcg/0.3 mL.	1,210	$130	$154.2K
90694	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is an inactivated, adjuvanted, preservative–free vaccine given as a 0.5 mL…	1,400	$80	$106.7K
90480	The provider administers the first or only component of a SARS–CoV–2 (COVID–19) vaccine by intramuscular injection to reduce the patient's risk of contracting COVID–19.	1,210	$40	$47K
G0008	Administration of influenza virus vaccine	1,460	$30	$42.4K
0124A	N/A	410	$40	$16K
90677	This code represents a vaccine product administered intramuscularly to protect against pneumococcal disease, a bacterial infection. This is a 20–valent vaccine, protecting against 20 strains of the…	30	$280	$7.6K
0134A	N/A	170	$40	$6.5K
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…	50	$60	$2.9K
90674	This code represents a flu vaccine product that protects against four strains of influenza. It is derived from cell cultures, contains no preservatives or antibiotics, and is administered as a 0.5 mL…	60	$30	$1.9K
0121A	N/A	50	$40	$1.9K

Showing 1–10 of 17

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Idaho Distribution

Derek Hamblin — 3 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. state median

17 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
91320	10	140	60	$130	$231.6K
90480	12	210	80	$40	$96K
90677	45	160	20	$280	$81.2K
G0008	12	410	50	$30	$42.3K
0134A	10	70	20	$40	$40.4K
0124A	10	80	30	$40	$39.8K
99214	2,589	2,690	90	$70	$10.4K
G0009	42	170	20	$30	$8.8K
90694	1	190	40	$70	$5.9K
99213	1,668	2,770	70	$50	$5.7K

Showing 1–10 of 17

Related Providers

Other providers that share a Tax Identification Number (TIN) with Derek Hamblin, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Alliance Medical Group, LLC	ID	Family Medicine Physician	$0	$21.8M
James Earls	VA	Diagnostic Radiology Physician	$177.9K	$4.6K
Rick Roberts	ID	Family Medicine Physician	$80.6K	$0
Bruce Belzer	ID	Family Medicine Physician	$73.4K	$0
Angela Pellant	ID	Family Medicine Physician	$46.3K	$0
Nicole Stivers	ID	Family Medicine Physician	$43.8K	$0
Christopher Boone	SC	Family Medicine Physician	$42.2K	$0
Shannon Gardiner	ID	Surgical Physician Assistant	$40K	$0
Tea Hasanovic	ID	Physician Assistant	$30.8K	$0
Zechariah Wilson	ID	Family Medicine Physician	$30.2K	$0

Nearby Providers

Other providers in the same ZIP code as Derek Hamblin, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saint Alphonsus Regional Medical Center Inc	ID	Family Medicine Physician	$0	$32.6M
Saint Alphonsus Regional Medical Center Inc	ID	Rural Health Clinic/Center	$0	$9.9M
Human Supports Of Idaho	ID	General Practice Physician	$0	$9.4M
County Of Canyon Canyon Co School Dist 132	ID	Local Education Agency (LEA)	$0	$8.3M
West Valley Medical Center, Inc.	ID	General Acute Care Hospital	$0	$7.8M
Carepoint Health Emergency Medicine Idaho, PLLC	ID	Emergency Medicine Physician	$0	$4.3M
Mana Resources LLC	ID	Community/Behavioral Health Agency	$0	$3.1M
Family Eyecare Specialists PLLC	ID	Optometrist	$0	$2.9M
Hope House, Inc.	ID	Developmentally Disabled Services Day Training Agency	$0	$2.4M
West Valley Medical Group LLC	ID	Internal Medicine Physician	$0	$2.1M

Derek Hamblin — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References