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.

St Lukes Clinic - Wood River LLC (NPI 1972891604)

St Lukes Clinic - Wood River LLC is a internal medicine physician provider located in Ketchum, Idaho. This profile covers 0 Medicare and 26 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	St Lukes Clinic - Wood River LLC
Address	100 Hospital Drive
City	Ketchum
State	ID
ZIP	83340
Taxonomy	Internal Medicine Physician
NPI Enumerated	July 15, 2011

Payer Source	Total Paid
Medicaid	$720.5K
Medicare	$0

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

26 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	8,790	$60	$527.2K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	3,700	$20	$66.5K
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…	540	$80	$43.7K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	200	$90	$18K
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.	170	$90	$15.8K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	220	$70	$15.3K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	460	$20	$8.7K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	50	$100	$5K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	20	$200	$3.3K
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.	50	$60	$3K

Showing 1–10 of 26

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

St Lukes Clinic - Wood River LLC — 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

26 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	54	60	1,080	$110	$595.5K
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.	53	80	1,020	$90	$502.7K
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.	73	80	880	$70	$265.5K
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…	78	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…	315	620	560	$60	$191.8K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	403	410	740	$60	$174.3K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	64	80	450	$80	$171.3K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	53	80	380	$70	$151.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	71	80	130	$80	$91.4K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	46	50	560	$60	$82.3K

Showing 1–10 of 26

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Luke's Clinic LLC	ID	Family Medicine Physician	$0	$39.5M
St Lukes Clinic - Mccall LLC	ID	Family Medicine Physician	$0	$575.7K
Garrett Coman	ID	Dermatology Physician	$186.9K	$0
Jason Greenhalgh	ID	Urology Physician	$178.8K	$0
Matthew Reeck	ID	Dermatology Physician	$172.1K	$0
Matthew Kopplin	MT	Orthopaedic Surgery Physician	$158.2K	$0
James Abbott	ID	Dermatology Physician	$94.7K	$0
Seth Wheeler	ID	Gastroenterology Physician	$90.7K	$0
Dan Fairman	ID	Internal Medicine Physician	$76.6K	$0
Autumn Loomis	ID	Emergency Medicine Physician	$37K	$25.7K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Blaine County	ID	Land Ambulance	$173.2K	$47K
Pharma Donna LLC	ID	Community/Retail Pharmacy	$160.7K	$0
Gene Branum	ID	Surgery Physician	$82.3K	$0
Gary Strachan	ID	Emergency Medicine Physician	$62.7K	$0
David Laxson	ID	Cardiovascular Disease Physician	$42.3K	$0
Anthony Buoncristiani	ID	Orthopaedic Surgery Physician	$31.5K	$0
Joanna Peters	ID	Family Nurse Practitioner	$27.6K	$0
Jennie Hooper	ID	Emergency Medicine Physician	$24.6K	$0
Kelly Dilorenzo	ID	Emergency Medicine Physician	$24.3K	$0
Rhonda Robbins	ID	Obstetrics & Gynecology Physician	$4.6K	$0

St Lukes Clinic - Wood River LLC — Billing Profile & Reimbursement Data

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St Lukes Clinic - Wood River LLC — 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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