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.

Caribou Memorial Hospital (NPI 1912998261)

Caribou Memorial Hospital is a critical access hospital provider located in Soda Springs, Idaho. This profile covers 0 Medicare and 24 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	Caribou Memorial Hospital
Address	300 S 3rd W
City	Soda Springs
State	ID
ZIP	83276
Taxonomy	Critical Access Hospital
NPI Enumerated	November 3, 2005

Payer Source	Total Paid
Medicaid	$467.4K
Medicare	$0

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

24 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.	550	$450	$248.2K
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.	440	$300	$131K
87631	The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,…	190	$120	$21.6K
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…	210	$60	$11.8K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	390	$30	$11.2K
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.	1,040	$10	$8.3K
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…	1,230	$10	$7.4K
87486	The lab analyst performs a test for Chlamydia pneumoniae using amplified nucleic acid probe technique. Chlamydia pneumoniae also known as TWAR, Taiwan Acute Respiratory agent, commonly causes mild…	190	$30	$6K
87581	The lab analyst performs a test for Mycoplasma pneumonia, a bacteria, using amplified nucleic acid probe technique.	190	$30	$6K
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	180	$30	$4.9K

Showing 1–10 of 24

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

Caribou Memorial Hospital — 0 of 22 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

24 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	44	80	1,020	$90	$502.7K
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…	185	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.	52	80	880	$70	$265.5K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	174	230	1,390	$40	$134.8K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	133	140	710	$20	$76.4K
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.	48	70	2,170	$10	$42.9K
87631	The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,…	3	10	140	$120	$37.8K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	47	50	940	$10	$34.2K
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…	49	90	1,410	$1	$27.8K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	58	70	190	$30	$16.7K

Showing 1–10 of 24

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Caribou Memorial Hospital	ID	Rural Health Clinic/Center	$0	$565.9K
David Johnson	FL	Vascular & Interventional Radiology Physician	$347.1K	$0
Aaron Heligman	FL	Vascular & Interventional Radiology Physician	$272.5K	$0
Jamel Reid	MD	Diagnostic Radiology Physician	$261.4K	$0
Pankit Parikh	FL	Vascular & Interventional Radiology Physician	$256.3K	$0
Cameron Evans	WA	Diagnostic Radiology Physician	$254.1K	$0
Sharik Rathur	FL	Diagnostic Radiology Physician	$240.7K	$0
Joseph D'alonzo	PA	Diagnostic Radiology Physician	$225.5K	$0
Christopher Johnson	IL	Vascular & Interventional Radiology Physician	$215.3K	$0
Sheeraz Daudi	MN	Diagnostic Radiology Physician	$206.6K	$2K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wesley Bowman	ID	Chiropractor	$38.8K	$111.1K
Douglas Ball	ID	Physical Therapist	$80.1K	$0
Sara Brown	ID	Registered Dietitian	$4K	$0
Joshua Torman	ID	Certified Registered Nurse Anesthetist	$1.8K	$0

Caribou Memorial Hospital — 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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