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.

Boundary Regional Community Health Center, Inc. (NPI 1811054877)

Field	Value
Entity Type	Organization
Organization	Boundary Regional Community Health Center, Inc.
Address	1033 Baldy Mountain Rd
City	Sandpoint
State	ID
ZIP	83864
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	January 2, 2007

Payer Source	Total Paid
Medicaid	$1.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D0999	N/A	5,920	$140	$828.7K
T1015	Clinic visit/encounter, all-inclusive	2,210	$170	$364K
D2392	Post 2 surface resin‑based composite	650	$150	$98.5K
D2393	Resin-based composite, three surfaces, posterior	140	$160	$22.8K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	870	$20	$16.5K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	30	$0	$0
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	290	$0	$0
D0120	Periodic oral evaluation - established patient	1,050	$0	$0
D0140	Limited oral evaluation – problem focused	150	$0	$0
D0150	Comprehensive oral evaluation – new or established patient	380	$0	$0

Showing 1–10 of 19

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

Boundary Regional Community Health Center, Inc. — 0 of 5 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

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	89	140	5,470	$180	$2.6M
D0999	N/A	12	30	3,960	$250	$1.5M
D1120	Prophylaxis–child	77	250	180	$60	$143K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	90	320	310	$80	$80.8K
D2392	Post 2 surface resin‑based composite	75	190	280	$60	$72.9K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	25	30	790	$30	$68.4K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	15	30	790	$20	$48.1K
D2393	Resin-based composite, three surfaces, posterior	35	70	140	$120	$41.6K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	101	110	300	$30	$32.4K
D2391	Resin‑based composite – one surface, posterior	41	140	270	$40	$27.9K

Showing 1–10 of 19

Related Providers

Other providers that share a Tax Identification Number (TIN) with Boundary Regional Community Health Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Boundary Regional Community Health Center, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$7M
Boundary Regional Community Health Center Inc	ID	Federally Qualified Health Center (FQHC)	$0	$5.5M
Sarah Rains	ID	Physician Assistant	$117.8K	$0
Magno Santos	ID	Family Nurse Practitioner	$58.1K	$720
Albert Jabbour	FL	Medical Physician Assistant	$8.1K	$0
James Mccall	ID	Physician Assistant	$550	$0

Nearby Providers

Other providers in the same ZIP code as Boundary Regional Community Health Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
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
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
Advanced Care Northwest LLC	ID	Non-emergency Medical Transport (VAN)	$0	$739.5K
Family Center For Occupational Therapy	ID	Occupational Therapist	$0	$569.9K

Boundary Regional Community Health Center, Inc. — Billing Profile & Reimbursement Data

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Boundary Regional Community Health Center, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References