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 Montana for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Montana 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. Montana (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.

James Clough (NPI 1013999846)

Field	Value
Entity Type	Individual
Organization	James Clough
Address	104 Rufus Ln
City	Polson
State	MT
ZIP	59860
Taxonomy	Podiatrist
NPI Enumerated	November 17, 2005

Payer Source	Total Paid
Medicare	$3.4K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

1 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
28285	The provider repairs a hammertoe deformity, a painful condition in which the toe remains permanently bent in a downward position.	20	$180	$3.4K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 1 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Montana Distribution

James Clough — 0 of 1 code billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. state median

1 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
28285	2	10	20	$330	$7K

Nearby Providers

Other providers in the same ZIP code as James Clough, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Polson Ambulance, Inc.	MT	Land Ambulance	$459.3K	$2.1M
Polson School District 23	MT	Local Education Agency (LEA)	$0	$1.6M
Providence St Joseph Medical Center	MT	Family Medicine Physician	$0	$1.1M
Montana Dental Group LLC	MT	General Practice Dentistry	$0	$1M
Michael Windauer	MT	General Practice Dentistry	$0	$673.1K
Kickin It Enterprises	MT	Clinical Social Worker	$0	$659.3K
Providence St Joseph Medical Center	MT	Critical Access Hospital	$0	$654.7K
Jeffrey Bird	MT	General Practice Dentistry	$0	$619.1K
Kalispell Regional Medical Center Inc	MT	Family Medicine Physician	$0	$418.9K
St Lukes Community Hospital	MT	Rural Health Clinic/Center	$0	$403.3K

James Clough — Billing Profile & Reimbursement Data

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James Clough — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References