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.

Scott Cross (NPI 1932186939)

Field	Value
Entity Type	Individual
Organization	Scott Cross
Address	3100 Channing Way
City	Idaho Falls
State	ID
ZIP	83404
Taxonomy	Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
NPI Enumerated	December 30, 2005

Payer Source	Total Paid
Medicare	$59.5K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	290	$130	$37.6K
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.	130	$80	$10.6K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	60	$160	$9.5K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	150	$10	$880
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.	20	$50	$810

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Idaho Distribution

Scott Cross — 1 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. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	7	240	110	$120	$15K
99291	65	240	40	$160	$8.5K
99284	40	240	70	$80	$6.8K
93010	100	290	80	$10	$1.4K
99283	91	140	20	$50	$1.3K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Scott Cross, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mountain View Hospital LLC	ID	General Acute Care Hospital	$0	$45.7M
Emergency Physicians Integrated Care, LLC	UT	Emergency Medicine Physician	$0	$31.2M
Eastern Idaho Health Services Inc	ID	General Acute Care Hospital	$0	$12.1M
Intermountain Emergency Physicians	ID	Emergency Medicine Physician	$0	$6.6M
Upper Valley Family Medicine PLLC	ID	Family Medicine Physician	$0	$1.9M
Wenshu Yu	UT	Rheumatology Physician	$396.3K	$0
James Blaine	ID	Medical Physician Assistant	$297.2K	$0
Cydney Mortensen	UT	Physician Assistant	$281K	$0
Terry Baker	ID	Otolaryngology Physician	$74.8K	$181.8K
John Chambers	ID	Cardiovascular Disease Physician	$239K	$0

Scott Cross — Billing Profile & Reimbursement Data

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Scott Cross — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Frequently Asked Questions

References