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 Luke's Clinic LLC (NPI 1790718229)

Field	Value
Entity Type	Organization
Organization	St Luke's Clinic LLC
Address	775 Pole Line Rd W
City	Twin Falls
State	ID
ZIP	83301
Taxonomy	Family Medicine Physician
NPI Enumerated	July 8, 2006

Payer Source	Total Paid
Medicaid	$39.5M
Medicare	$0

Key Findings

This entity is effectively a single‑payer Medicaid provider: there is no Medicare billing on file and total Medicaid revenue is $39.5M, indicating Medicaid is the dominant — and for these records the only — payer driving scale for the practice. The absence of Medicare activity means comparisons to national Medicare peer groups are not applicable for this profile.

Revenue is highly concentrated in a small set of ambulatory and emergency E/M codes: the precomputed top 3 Medicaid codes account for 54.0% of total Medicaid revenue, with 99213 contributing $8.9M (24.3%), 99214 contributing $7M (19.0%), and 99285 contributing $3.9M (10.7%). This concentration shows the business is heavily dependent on routine established-patient visits and higher-acuity emergency visits for its Medicaid revenue base.

The code mix points to a combined primary care and acute/ED service profile: very large volumes in office visit codes 99213 (167.9K claims) and 99214 (110.5K claims) alongside substantial ED-level billing (99285, 36K claims; 99284, 32.1K claims) suggest the provider operates high-throughput ambulatory clinics coupled with emergency department or urgent care–level services. Preventive visit codes 99391 and 99392 are also material, indicating ongoing well‑care delivery across age groups.

Competitive standing within Idaho is prominent for core service lines: 99213 and 99214 both rank #3 statewide and are labeled "extreme outlier, far above typical state volume," while 99285 ranks #2 of 57 (98th percentile, "notably above typical state volume"). Those percentile and rank positions indicate this provider is a major volume leader in the state for both routine ambulatory E/M and higher‑acuity ED visits.

The provider also generates meaningful revenue from non‑E/M services and procedures, signaling diversified ambulatory offerings beyond visits alone: T1015 ($3.1M, 8.5%), J0585 ($1.9M, 5.3% and rank #1 of 10), 74177 ($587.7K), and immunization administration 90471 ($601.8K) and 90472 ($384.4K) are all notable contributors. J0585 ranking #1 of 10 and its 100th/"notably above" label point to a relatively unique or specialized injectable therapy volume in‑state.

Operational scale implications are clear from high claim counts: 167.9K claims for 99213 and 110.5K claims for 99214 reflect very large ambulatory throughput and imply substantial staffing, scheduling, and throughput infrastructure to support those visit volumes. High claim volumes for 90471 (37.6K claims) and 93010 (43.1K claims) further underscore broad preventive and basic diagnostic activity across the practice.

Inpatient and observation care are present and material: hospital initial care code 99223 contributes $345.6K and ranks #1 of 44 (100th percentile, "extreme outlier"), and subsequent inpatient visits (99232) also appear in the top codes. This spread from preventive and clinic visits through ED and inpatient codes indicates the provider bills across the continuum of ambulatory, emergency, and inpatient evaluation and management.

The provider has long tenure in the enrollment file (NPI enumerated ~2006-07-08, ~20 years ago), which, when combined with the high statewide ranks and extreme‑outlier volumes on multiple codes, suggests an established regional footprint and sustained operational capacity rather than a recent or transient billing pattern.

Medicaid: Complete Services Breakdown

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

211 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	167,910	$50	$8.9M
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…	110,540	$60	$7M
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.	36,050	$110	$3.9M
T1015	Clinic visit/encounter, all-inclusive	31,330	$100	$3.1M
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.	32,090	$90	$2.7M
J0585	Injection, onabotulinumtoxina, 1 unit	2,680	$720	$1.9M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	12,520	$100	$1.2M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	13,300	$80	$1.1M
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.	16,440	$50	$805.6K
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…	10,370	$80	$798.4K

Showing 1–10 of 211

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 Luke's Clinic LLC — 18 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

211 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	18	140	5,470	$180	$2.6M
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.	2	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.	3	80	1,020	$90	$502.7K
J0585	Injection, onabotulinumtoxina, 1 unit	1	10	300	$510	$359.7K
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.	4	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.	4	40	530	$70	$237.8K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	3	20	110	$840	$224.4K
00170	The provider performs anesthesia services for a patient undergoing an intraoral procedure, including biopsy.	19	20	230	$180	$199K
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	3	10	2,080	$100	$194.4K
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…	3	670	740	$40	$193.6K

Showing 1–10 of 211

Related Providers

Other providers that share a Tax Identification Number (TIN) with St Luke's Clinic LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Lukes Clinic-treasure Valley LLC	ID	Family Medicine Physician	$0	$59.2M
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
Nathan Welch	ID	Ophthalmology Physician	$1.1M	$0
Pejman Rohani	MD	Vascular Surgery Physician	$1M	$0
St Lukes Clinic - Wood River LLC	ID	Internal Medicine Physician	$0	$720.5K
Peter Castellanos	ID	Neurology with Special Qualifications in Child Neurology Physician	$0	$599.5K
St Lukes Clinic - Mccall LLC	ID	Family Medicine Physician	$0	$575.7K

Nearby Providers

Other providers in the same ZIP code as St Luke's Clinic LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Homestyle Direct LLC.	ID	Home Delivered Meals	$0	$65.4M
Primary Therapy Source, LLC	ID	Physical Therapist	$0	$11.7M
Wright Physical Therapy Limited Partnership	ID	Physical Therapist	$0	$8.8M
Smiles 4 Kids, LLC	ID	Pediatric Dentistry	$0	$8.7M
Family Health Services Corporation	ID	Federally Qualified Health Center (FQHC)	$0	$8.1M
St. Luke's Magic Valley Regional Medical Center, Ltd.	ID	General Acute Care Hospital	$0	$7.9M
Twin Falls School District #411	ID	Local Education Agency (LEA)	$0	$6.6M
Sunshine Therapy LLC	ID	Behavior Analyst	$0	$5.7M
Magic Valley Paramedics L L C	ID	Land Ambulance	$976.6K	$4.6M
Twin Falls Senior Living LLC	ID	Assisted Living Facility	$0	$4.6M

St Luke's Clinic LLC — Billing Profile & Reimbursement Data

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St Luke's Clinic LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References