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.

Pioneer Family Medicine PLLC (NPI 1952335929)

Pioneer Family Medicine PLLC is a family medicine physician provider located in Meridian, Idaho. This profile covers 0 Medicare and 22 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	Pioneer Family Medicine PLLC
Address	4740 N. Penngrove Way
City	Meridian
State	ID
ZIP	83646
Taxonomy	Family Medicine Physician
NPI Enumerated	July 10, 2006

Payer Source	Total Paid
Medicaid	$454.8K
Medicare	$0

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	10,690	$20	$224.6K
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…	1,580	$60	$91.6K
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…	710	$80	$56.2K
99310	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends…	650	$40	$22.8K
99306	The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves high medical decision making, and/or the provider spends at least…	300	$50	$14.8K
99349	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	350	$40	$13.3K
99350	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves high medical decision making or the provider spends at least 60…	200	$60	$11K
99348	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves low medical decision making or the provider spends at least 30…	270	$20	$6.3K
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…	230	$20	$4.1K
99334	N/A	260	$10	$3.1K

Showing 1–10 of 22

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

Pioneer Family Medicine PLLC — 0 of 17 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

22 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…	249	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…	281	620	560	$60	$191.8K
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…	4	30	790	$30	$68.4K
99349	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	11	20	580	$40	$53.7K
99204	The provider sees a new 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 provider…	137	180	70	$110	$45.6K
99310	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends…	7	20	200	$40	$33.1K
99350	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves high medical decision making or the provider spends at least 60…	7	10	340	$40	$26K
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…	14	30	140	$20	$15K
99336	N/A	12	20	210	$20	$14.5K
99306	The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves high medical decision making, and/or the provider spends at least…	4	10	70	$50	$14K

Showing 1–10 of 22

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tracy Roberts	ID	Family Nurse Practitioner	$171.1K	$0
Jan King	ID	Family Nurse Practitioner	$104.2K	$0
Scot Klein	ID	Family Nurse Practitioner	$60.4K	$0
Scott Willoughby	ID	Family Nurse Practitioner	$41.9K	$0
Josie Farmer	ID	Family Nurse Practitioner	$21.2K	$0
Kaylee Norman	ID	Psychiatric/Mental Health Nurse Practitioner	$19.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
A New Leaf, Inc.	ID	Developmentally Disabled Services Day Training Agency	$0	$29.5M
Southern Idaho Surgery Center PLLC	ID	Ambulatory Surgical Clinic/Center	$0	$5.3M
A Helping Hand In Home Care	ID	In Home Supportive Care Agency	$0	$3.6M
Dental Care For Kids	ID	Pediatric Dentistry	$0	$3.1M
Watchdog LLC	ID	Emergency Response System Companies	$0	$2.4M
Idaho Transition Care, LLC	ID	Case Management Agency	$0	$2.1M
Small Talk Speech & Language Services	ID	Speech-Language Pathologist	$0	$1.8M
D&g Medical Associates PLLC	ID	Family Medicine Physician	$0	$1.3M
Capitol Healthcare, Inc.	ID	In Home Supportive Care Agency	$0	$1.3M
Mountain Pine Dermatology, PLLC	ID	Dermatology Physician	$0	$1.2M

Pioneer Family Medicine PLLC — Billing Profile & Reimbursement Data

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Pioneer Family Medicine 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

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