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.

Sandpoint Family Health Center, PLLC (NPI 1881613321)

Field	Value
Entity Type	Organization
Organization	Sandpoint Family Health Center, PLLC
Address	606 N 3rd Ave
City	Sandpoint
State	ID
ZIP	83864
Taxonomy	Primary Care Clinic/Center
NPI Enumerated	July 18, 2006

Payer Source	Total Paid
Medicaid	$515.2K
Medicare	$0

Medicaid: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	3,970	$90	$353.2K
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…	2,880	$60	$161.3K
0011A	N/A	10	$40	$460
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	10	$10	$130
1159F	No Summary found for this code	350	$0	$0
1160F	No Summary found for this code	340	$0	$0
3074F	No Summary found for this code	160	$0	$0
3078F	No Summary found for this code	80	$0	$0
91301	N/A	10	$0	$0
G0444	Annual depression screening, 5 to 15 minutes	30	$0	$0

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

Sandpoint Family Health Center, PLLC — 0 of 4 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

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	174	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…	91	620	560	$60	$191.8K
0011A	N/A	32	30	30	$20	$2.8K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	157	160	110	$1	$2K
1159F	No Summary found for this code	27	40	840	$1	$20
1160F	No Summary found for this code	26	40	970	$1	$10
3078F	No Summary found for this code	45	60	580	$1	$10
3074F	No Summary found for this code	45	60	770	$1	$10
91301	N/A	32	30	50	$0	$0
G0444	Annual depression screening, 5 to 15 minutes	4	10	60	$0	$0

Related Providers

Other providers that share a Tax Identification Number (TIN) with Sandpoint Family Health Center, PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Zachary Halversen	ID	Family Medicine Physician	$119.5K	$0
Daniel Meulenberg	ID	Family Medicine Physician	$95K	$0
Hannah Raynor	ID	Family Medicine Physician	$90.1K	$0
Scott Dunn	ID	Family Medicine Physician	$82.1K	$0
Jeremy Waters	ID	Family Medicine Physician	$69.4K	$0

Nearby Providers

Other providers in the same ZIP code as Sandpoint Family Health Center, PLLC, 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
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
Boundary Regional Community Health Center, Inc.	ID	Federally Qualified Health Center (FQHC)	$0	$1.3M
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

Sandpoint Family Health Center, PLLC — Billing Profile & Reimbursement Data

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Sandpoint Family Health Center, PLLC — 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