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.

Pocatello Hospital LLC (NPI 1790751055)

Pocatello Hospital LLC is a general acute care hospital provider located in Pocatello, Idaho. This profile covers 0 Medicare and 265 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	Pocatello Hospital LLC
Address	777 Hospital Way
City	Pocatello
State	ID
ZIP	83201
Taxonomy	General Acute Care Hospital
NPI Enumerated	February 27, 2006

Payer Source	Total Paid
Medicaid	$6.1M
Medicare	$0

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

265 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	5,430	$120	$630.2K
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.	4,080	$140	$559.5K
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…	1,300	$330	$431.6K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	5,510	$60	$325K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	5,360	$60	$311K
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.	2,670	$110	$291K
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.	2,040	$100	$206K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	130	$1,320	$167.1K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	26,030	$10	$156.2K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	26,900	$1	$107.6K

Showing 1–10 of 265

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

Pocatello Hospital LLC — 4 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

265 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	15	20	500	$820	$662.5K
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.	13	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.	19	80	1,020	$90	$502.7K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	69	280	1,480	$70	$389.4K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	77	210	3,020	$50	$389K
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.	28	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.	14	40	530	$70	$237.8K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	11	20	4,340	$10	$236.8K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	11	20	110	$840	$224.4K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	18	30	1,450	$50	$160K

Showing 1–10 of 265

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pocatello Health Services, LLC	ID	General Acute Care Hospital	$0	$3.1M
Portneuf Asc, LLC	ID	Ambulatory Surgical Clinic/Center	$182.6K	$145.9K
Jared Price	ID	Family Medicine Physician	$55.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Moonlight Mountain Recovery, Inc	ID	Substance Abuse Rehabilitation Facility	$0	$17.7M
Pocatello Children & Adolescent Clinic	ID	Pediatrics Physician	$0	$11M
Speech Therapy Services, LLC	ID	Speech-Language Pathologist	$0	$8.5M
Pocatello Chubbuck School District #25	ID	Local Education Agency (LEA)	$0	$7.9M
Facial & Oral Surgery Associates, Inc.	ID	Oral and Maxillofacial Surgery (Dentist)	$0	$6.3M
Health West, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$6.2M
Health West, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$5.9M
Rocky Mountain Physician Group LLC	ID	Emergency Medicine Physician	$0	$5.5M
Community Mental Health	ID	Community/Behavioral Health Agency	$0	$4.3M
Medical Imaging Associates Of Idaho Falls, Inc	ID	Diagnostic Radiology Physician	$0	$4.2M

Pocatello Hospital LLC — Billing Profile & Reimbursement Data

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Pocatello Hospital LLC — 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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