JAMES P EDLIN MD
NPI 1346329919
Radiology - Diagnostic Radiology in Idaho Falls, ID

Medicare Participation & PECOS Enrollment Status

James Edlin is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Durable Medical Equipment (DME) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

• Is the provider registered in PECOS? Yes

• Eligible to Order or Refer Part B Clinical Laboratory and Imaging: No

• Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

• Eligible to Order or Refer a Home Health Agency (HHA): No

• Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician

An exercise or drug-induced heart stress test with ECG is a procedure performed by a doctor to assess how your heart responds to exertion. It involves monitoring your heart's electrical activity while you exercise or after medication is given to mimic exercise effects.

This service was performed 182 times for 181 patients

Injection, regadenoson, 0.1 mg

Regadenoson injection, 0.1 mg, is a medication used to help visualize the heart during a stress test. It works by increasing blood flow in the arteries of the heart. It's injected into a vein and is generally well-tolerated.

This service was performed 540 times for 134 patients

Injection, sincalide, 5 micrograms

Sincalide injection, containing 5 micrograms of the active ingredient, is a procedure used to stimulate your digestive system. It helps in assessing gallbladder function or diagnosing issues related to the pancreas or bile ducts. It's a safe, quick procedure.

This service was performed 19 times for 19 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

This service was performed 183 times for 182 patients

Nuclear medicine study of bone and/or joint whole body

A nuclear medicine study of bone and/or joint whole body involves injecting a small amount of radioactive material into your body. This material travels to your bones and emits energy. A special camera captures this energy, creating images of your bones to help identify any abnormalities.

This service was performed 36 times for 36 patients

Nuclear medicine study of bone taken at different times

A nuclear medicine bone study involves injecting a small amount of radioactive material into your body. This material collects in the bones and is detected by a special camera to create images. These images are taken at different times to track changes and help diagnose bone conditions.

This service was performed 19 times for 19 patients

Nuclear medicine study of liver and bile duct system with use of drugs

A nuclear medicine study of the liver and bile duct system involves injecting a safe, radioactive substance into the body. This substance helps create images of these areas on a special camera. It's often combined with drug use to improve image clarity and aid in diagnosing various conditions.

This service was performed 27 times for 27 patients

Nuclear medicine study of parathyroid with spect

A nuclear medicine study of the parathyroid with SPECT is a diagnostic test that uses a small amount of radioactive material and a special camera to create images of your parathyroid glands. This test helps identify any abnormalities, aiding in accurate diagnosis and treatment.

This service was performed 49 times for 49 patients

Nuclear medicine study of stomach to assess emptying

A nuclear medicine study of the stomach assesses how quickly food leaves the stomach. A safe, radioactive substance is added to a meal. The radiation emitted is tracked, creating images that show the food's progress through the stomach. It's non-invasive and painless.

This service was performed 17 times for 17 patients

Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries

Technetium Tc-99m Mebrofenin is a diagnostic test used to assess your liver function. A small amount of a radioactive substance is injected into your body, which helps create images of your liver for detailed examination. It's safe and essential for accurate diagnosis.

This service was performed 27 times for 27 patients

Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries

Technetium Tc-99m Medronate is a diagnostic procedure that uses a small amount of radioactive material to examine the health of your bones. It helps to detect bone diseases or abnormalities. The procedure is safe, with the radioactive substance naturally leaving your body after the test.

This service was performed 57 times for 57 patients

Technetium tc-99m sestamibi, diagnostic, per study dose

Technetium Tc-99m Sestamibi is a diagnostic test used to create images of your heart or breast tissues. It involves a safe radioactive substance injection that helps doctors to detect any abnormalities or changes in these tissues.

This service was performed 360 times for 152 patients

Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries

Technetium Tc-99m sulfur colloid is used in diagnostic imaging tests. It helps to highlight areas of concern in the body by emitting a small amount of radiation that can be detected by a special camera. This helps doctors to diagnose and monitor various health conditions.

This service was performed 17 times for 17 patients

Thallium tl-201 thallous chloride, diagnostic, per millicurie

Thallium Tl-201 Thallous Chloride is a radioactive substance used in medical imaging. It's administered into your body to highlight areas of abnormal cell activity during scans. This helps in diagnosing conditions like heart disease or cancer.

This service was performed 316 times for 79 patients

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 83404 ZIP code area.

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 0, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

• Final Score: 0 out of 100

  The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
  
  

• Quality Score: 0

  The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
  
  There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
  
  

• Promoting Interoperability Score: N/A

  The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
  
  The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

• Improvement Activities Score: 0

  The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
  
  The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

• Cost Score: N/A

  The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
  
  Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

• Cost Score: N/A

  The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
  
  Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

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