Clinic
Benewah Medical Center
Benewah Medical Center was paid $25.51M by Medicaid between Jan 2018 and Dec 2024, across 80 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 75% of everything it billed.
33Billing provider infoBENEWAH MEDICAL CENTER
PLUMMER, ID 83851
PLUMMER, ID 83851
33aNPI1366637068assigned 09/06/2007
33bProvider typeHealth Service Clinic/Center
28Total paid$25.51M
24GClaims138,158
24DCodes billed80
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Health Service Clinic/Center providers in Idaho
Rank by total paid#1 of 8
Median peer was paid$95K
This provider vs. median267×
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 | 12,599 | $1.65M | |
| 2019 | 14,328 | $2.07M | |
| 2020 | 17,945 | $2.84M | |
| 2021 | 22,357 | $3.84M | |
| 2022 | 26,390 | $5.50M | |
| 2023 | 26,598 | $5.39M | |
| 2024incomplete | 17,941 | $4.23M |
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 | 75% | 37,927 | 26,240 | $19.13M |
| D0999 | Unspecified diagnostic procedure, by report | 23% | 11,097 | 10,567 | $5.86M |
| 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% | 12,622 | 10,635 | $108K |
| 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% | 12,663 | 10,708 | $105K |
| 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% | 4,583 | 3,344 | $105K |
| 36415 | Collection of venous blood by venipuncture | <1% | 5,267 | 4,933 | $25K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,730 | 1,606 | $24K |
| 98941 | Chiropractic manipulative treatment; spinal, 3-4 regions | <1% | 1,575 | 1,087 | $18K |
| 80053 | Comprehensive metabolic panel | <1% | 3,184 | 3,055 | $13K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | <1% | 1,708 | 1,706 | $13K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 3,495 | 3,339 | $12K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 2,563 | 2,557 | $11K |
68 more codes
| 87400 | <1% | 2,554 | $10K | |
| 98940 | <1% | 1,039 | $9K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 1,241 | $8K |
| 92015 | Determination of refractive state | <1% | 1,473 | $8K |
| 80061 | Lipid panel | <1% | 2,005 | $8K |
| 87430 | <1% | 1,471 | $6K | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 1,948 | $6K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 817 | $6K |
| 81001 | <1% | 1,057 | $5K | |
| 87081 | <1% | 586 | $3K | |
| 81003 | <1% | 940 | $3K | |
| D1999 | <1% | 1,089 | $2K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 795 | $2K |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 359 | $1K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 491 | $685.90 |
| Q2038 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) | <1% | 13 | $601.30 |
| 71046 | Radiologic examination, chest; 2 views | <1% | 27 | $596.36 |
| U0001 | Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel | <1% | 584 | $476.57 |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 61 | $476.18 |
| G0008 | Administration of influenza virus vaccine | <1% | 12 | $464.62 |
| 98943 | <1% | 248 | $239.50 | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 2,148 | $234.89 |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 142 | $233.85 |
| 81025 | <1% | 381 | $225.96 | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 14 | $176.56 |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 1,140 | $141.16 |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 14 | $109.34 |
| D0330 | Panoramic radiographic image | <1% | 369 | $25.60 |
| 90688 | <1% | 181 | $17.65 | |
| D0274 | Bitewings - four radiographic images | 0% | 1,269 | $0.00 |
| D1110 | Prophylaxis - adult | 0% | 1,474 | $0.00 |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 0% | 50 | $0.00 |
| D1120 | Dental cleaning, child | 0% | 99 | $0.00 |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 0% | 60 | $0.00 |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 0% | 65 | $0.00 |
| D4910 | 0% | 90 | $0.00 | |
| 86708 | 0% | 51 | $0.00 | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 0% | 58 | $0.00 |
| 96158 | 0% | 79 | $0.00 | |
| 90461 | 0% | 107 | $0.00 | |
| 80348 | 0% | 50 | $0.00 | |
| G0470 | Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit | 0% | 15 | $0.00 |
| 90715 | 0% | 12 | $0.00 | |
| 91313 | 0% | 12 | $0.00 | |
| 91322 | 0% | 17 | $0.00 | |
| D1206 | Topical application of fluoride varnish | 0% | 982 | $0.00 |
| D0120 | Dental checkup, returning patient | 0% | 1,813 | $0.00 |
| D0140 | Limited oral evaluation - problem focused | 0% | 464 | $0.00 |
| 80048 | Basic metabolic panel (calcium, ionized) | 0% | 24 | $0.00 |
| 86706 | 0% | 51 | $0.00 | |
| 86803 | 0% | 179 | $0.00 | |
| 86704 | 0% | 50 | $0.00 | |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 0% | 74 | $0.00 |
| D0150 | Comprehensive oral evaluation - new or established patient | 0% | 428 | $0.00 |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | 0% | 184 | $0.00 |
| 93000 | 0% | 12 | $0.00 | |
| 87340 | 0% | 64 | $0.00 | |
| 91301 | 0% | 12 | $0.00 | |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | 0% | 65 | $0.00 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | 0% | 151 | $0.00 |
| 0134A | 0% | 13 | $0.00 | |
| 90656 | 0% | 20 | $0.00 | |
| D7140 | Extraction, erupted tooth or exposed root | 0% | 54 | $0.00 |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | 0% | 56 | $0.00 |
| D0272 | Bitewings - two radiographic images | 0% | 36 | $0.00 |
| 90480 | 0% | 18 | $0.00 | |
| D0220 | Intraoral - periapical first radiographic image | 0% | 3,964 | $-1038.00 |
| D0230 | Intraoral - periapical each additional radiographic image | 0% | 4,323 | $-1678.00 |
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 (FINANCE DIRECTOR)
| Provider | Location | Paid |
|---|---|---|
| Benewah Medical Center | Plummer, ID | $5.29M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.