Physician

Heather Mcguire, MD

According to 2025 Medicare claims, Heather Mcguire, MD (NPI: 1508806100) practices nephrology in the Twin Falls, ID market, with the plurality of this provider's patient population coming from Twin Falls, ID. This provider's primary affiliated billing organization is ST LUKE'S CLINIC LLC (NPI: 1790718229; TIN: 45-2716222) and primary practice location at 83301-3042. Mcguire is affiliated with the Caravan Health ACO 50 LLC (ACO ID: A5160), MountainStar Care Partners ACO (ACO ID: A5181), and St. Luke's Clinic Coordinated Care, Ltd (ACO ID: D0059), participating under both the MSSP and REACH models.

Mcguire's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 369 traditional Medicare patients, billed 1,075 HCPCS/CPT codes, and received $123,739 in Medicare payments. The top billing code was 90960 (Dialysis services, 4 or more physician visits per month (20 years or older)). Part D data shows 913 prescription claims across 250 beneficiaries totaling $41,356 in drug costs, led by Sevelamer Carbonate (Sevelamer Carbonate). DME data shows 151 claims. No Open Payments records. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing has fallen sharply in recent years, from $303,658 to $123,739. Similarly, Part D prescription costs have fallen sharply in recent years, from $290,467 to $41,356. In contrast, DME billing represents a smaller volume and moved up and down with repeated peaks and valleys, starting at $2,380 and ending at $1,124.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	755	3,208	$303,658
2016	811	3,604	$299,480
2017	851	4,189	$366,594
2018	883	4,032	$364,468
2019	849	3,534	$328,291
2020	957	3,285	$344,337
2021	980	3,197	$387,847
2022	964	2,667	$321,658
2023	721	1,307	$166,172
2024	369	1,075	$123,739

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	345	4,336	$290,467
2016	356	4,052	$309,568
2017	376	4,223	$382,265
2018	379	3,802	$280,754
2019	338	3,111	$234,952
2020	371	3,179	$269,650
2021	364	3,103	$284,184
2022	337	2,505	$246,823
2023	313	1,837	$129,363
2024	250	913	$41,356

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

Year	Patients	Claims	Payment
2015	195	1,781	$160,742
2016	189	2,029	$158,694
2017	172	1,774	$130,979
2018	166	1,909	$147,827
2019	171	1,741	$123,761
2020	171	1,766	$117,365
2021	162	1,676	$101,090
2022	144	1,589	$74,163
2023	125	1,088	$44,033
2024	12	151	$13,454

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
90960	Dialysis services, 4 or more physician visits per month (20 years or older)	47	187	$277
99223	Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	28	32	$131
99204	New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	113	113	$95
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	230	479	$70
99232	Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	46	135	$61

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Sevelamer Carbonate	Sevelamer Carbonate	17	533	$3,484
Potassium Citrate Er	Potassium Citrate	27	989	$2,664
Mycophenolate Mofetil	Mycophenolate Mofetil	11	600	$1,439
Potassium Chloride	Potassium Chloride	45	3,090	$1,371
Bumetanide	Bumetanide	31	1,590	$1,316

Top 5 DME services in 2024

By Total Medicare Payment Amount.

HCPCS Code	HCPCS Description	Supplier Rental Indicator	Total Supplier Beneficiaries	Total Supplier Claims	Total Medicare Payment Amount
J7503	Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg	N	N/R	16	$10,570
J7518	Mycophenolic acid, oral, 180 mg	N	N/R	26	$1,776
Q0511	Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period	N	12	36	$500
Q0512	Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period	N	N/R	39	$414
J7507	Tacrolimus, immediate release, oral, 1 mg	N	N/R	20	$187

Open Payments Summary

No connected Open Payments records were found for this physician in General Payments, Research Payments, or Ownership / Investment Interests.

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FAQ

What Medicare data is available for Heather Mcguire, MD?

Tedicare shows public-source Medicare data for Heather Mcguire, MD (NPI 1508806100), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Heather Mcguire, MD have ACO affiliation data?

Heather Mcguire, MD is shown with ACO affiliation data for Caravan Health ACO 50 LLC (MSSP, ACO ID A5160), MountainStar Care Partners ACO (MSSP, ACO ID A5181), and St. Luke's Clinic Coordinated Care, Ltd (REACH, ACO ID D0059).

What billing organization is linked to Heather Mcguire, MD?

Heather Mcguire, MD is linked to ST LUKE'S CLINIC LLC (billing NPI 1790718229) in the available physician profile data.

Does Heather Mcguire, MD have Open Payments data?

No connected Open Payments records are shown for this physician in the available General Payments, Research Payments, or Ownership / Investment Interests data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.