Clinic
Benewah Medical Center
Benewah Medical Center was paid $5.29M by Medicaid between Jan 2018 and Oct 2024, across 26 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 96% of everything it billed.
33Billing provider infoBENEWAH MEDICAL CENTER
PLUMMER, ID 83851
PLUMMER, ID 83851
33aNPI1336135136assigned 09/27/2005
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$5.29M
24GClaims17,832
24DCodes billed26
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in Idaho
Rank by total paid#6 of 21
Median peer was paid$2.73M
This provider vs. median1.9×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 1,842 | $320K | |
| 2019 | 2,562 | $451K | |
| 2020 | 3,483 | $1.07M | |
| 2021 | 3,050 | $897K | |
| 2022 | 3,046 | $1.14M | |
| 2023 | 2,376 | $862K | |
| 2024incomplete | 1,473 | $547K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 96% | 12,410 | 10,346 | $5.10M |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 1.5% | 1,297 | 998 | $79K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 1,284 | 1,006 | $36K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | <1% | 423 | 380 | $30K |
| G0467 | Community health center visit, returning patientFederally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | <1% | 436 | 335 | $20K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 151 | 140 | $6K |
| 92015 | Determination of refractive state | <1% | 318 | 286 | $3K |
| U0001 | Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel | <1% | 111 | 100 | $3K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 334 | 324 | $3K |
| D1110 | Prophylaxis - adult | <1% | 37 | 37 | $2K |
| D1206 | Topical application of fluoride varnish | <1% | 84 | 84 | $1K |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | <1% | 52 | 25 | $1K |
14 more codes
| D0140 | Limited oral evaluation - problem focused | <1% | 53 | $911.33 |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 64 | $835.70 |
| D0274 | Bitewings - four radiographic images | <1% | 52 | $672.26 |
| 36415 | Collection of venous blood by venipuncture | <1% | 321 | $626.26 |
| 98941 | Chiropractic manipulative treatment; spinal, 3-4 regions | <1% | 51 | $429.84 |
| D0330 | Panoramic radiographic image | <1% | 12 | $390.31 |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 189 | $384.21 |
| D0120 | Dental checkup, returning patient | <1% | 21 | $358.98 |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 14 | $358.12 |
| 87400 | <1% | 30 | $295.62 | |
| 80053 | Comprehensive metabolic panel | <1% | 27 | $215.70 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 27 | $139.24 |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 17 | $100.49 |
| 98943 | 0% | 17 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialBERGLAND, PAUL (CHIEF FINANCIAL OFFICER)
| Provider | Location | Paid |
|---|---|---|
| Benewah Medical Center | Plummer, ID | $25.51M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.