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.

North Idaho Nephrology Associates, Inc. (NPI 1912181090)

North Idaho Nephrology Associates, Inc. is a medical specialty clinic/center provider located in Hayden, Idaho. This profile covers 0 Medicare and 10 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	North Idaho Nephrology Associates, Inc.
Address	1986 W Hayden Ave Ste C
City	Hayden
State	ID
ZIP	83835
Taxonomy	Medical Specialty Clinic/Center
NPI Enumerated	December 24, 2007

Payer Source	Total Paid
Medicaid	$504.4K
Medicare	$0

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
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	8,710	$30	$270K
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…	2,630	$50	$118.2K
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	1,560	$50	$77.8K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	320	$60	$17.6K
90961	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the…	190	$40	$8.3K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	50	$70	$3.3K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	40	$80	$3.2K
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	330	$10	$3K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	20	$110	$1.8K
99496	The provider manages the care of a patient during the transition to home care after discharge from a healthcare facility. The patient’s care requires high–level medical decision making, contact…	10	$90	$1.2K

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

North Idaho Nephrology Associates, Inc. — 0 of 10 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
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…	138	620	560	$60	$191.8K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	7	20	200	$90	$158.3K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	7	60	1,370	$50	$151.3K
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	3	10	690	$70	$77.2K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	40	40	300	$120	$66.3K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	97	140	100	$90	$54.4K
90961	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the…	4	10	510	$50	$38.3K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	23	30	180	$70	$25.2K
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	14	40	180	$10	$7.1K
99496	The provider manages the care of a patient during the transition to home care after discharge from a healthcare facility. The patient’s care requires high–level medical decision making, contact…	1	10	10	$90	$1.2K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shaun Joshi	ID	Nephrology Physician	$523.4K	$0
Sherwin Foster	ID	Nephrology Physician	$356.3K	$0
David Fremouw	ID	Physician Assistant	$6.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Renewed Horizons, LLC	ID	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$19.9M
Wellspring Meadows, Inc.	ID	Personal Care Attendant	$0	$3.9M
Dance Dentistry PLLC	ID	General Practice Dentistry	$0	$2.6M
Periwinkle Children's Therapy	ID	Contractor	$0	$1.8M
Renewed Horizons, LLC	ID	Developmentally Disabled Services Day Training Agency	$0	$1.3M
Lookout Behavioral Health LLC	ID	Adult Mental Health Clinic/Center	$0	$888.5K
Public Health District 1	ID	Public Health or Welfare Agency	$0	$843.3K
Robin Lindauer	ID	Optometrist	$129.3K	$330.6K
Joshua Tree Physical Therapy PLLC	ID	Specialist	$0	$373.1K
Kevin Sgroi	ID	Physical Therapist	$222K	$0

North Idaho Nephrology Associates, Inc. — Billing Profile & Reimbursement Data

Sign up for North Idaho Nephrology Associates, Inc. — Billing Profile & Reimbursement Data policy alerts

North Idaho Nephrology Associates, Inc. — Billing Profile & Reimbursement Data

Sign up for North Idaho Nephrology Associates, Inc. — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References