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.

Cogent Healthcare Of Montana P C (NPI 1053569525)

Cogent Healthcare Of Montana P C is a internal medicine physician provider located in Missoula, Montana. This profile covers 0 Medicare and 11 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Cogent Healthcare Of Montana P C
Address	2827 Fort Missoula Rd
City	Missoula
State	MT
ZIP	59804
Taxonomy	Internal Medicine Physician
NPI Enumerated	September 8, 2008

Payer Source	Total Paid
Medicaid	$1.9M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	15,150	$60	$939.2K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	4,890	$130	$636K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	3,860	$40	$158.3K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	2,230	$70	$144.6K
99497	The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…	1,020	$30	$33.8K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	100	$180	$18.8K
99220	N/A	210	$60	$12.5K
99217	N/A	50	$30	$1.2K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	20	$70	$1.1K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	40	$30	$980

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Montana providers billing the same CPT/HCPCS codes.

Claims Volume vs. Montana Distribution

Cogent Healthcare Of Montana P C — 3 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. Montana median

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	7	30	770	$60	$233.3K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	1	30	640	$90	$188.1K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	11	20	100	$160	$100.9K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	1	30	60	$150	$77.9K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	18	20	150	$110	$67.6K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	3	20	110	$90	$59.5K
99220	N/A	2	10	210	$90	$32K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	14	20	60	$70	$26K
99217	N/A	3	10	30	$70	$21.6K
99497	The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…	1	10	50	$30	$12K

Showing 1–10 of 11

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shahid Chaudhary	MT	Nephrology Physician	$268.2K	$0
Varghese Parambi	MT	Nephrology Physician	$243.5K	$0
John Pullman	MT	Internal Medicine Physician	$202.5K	$0
Gaurav Ahuja	IA	Internal Medicine Physician	$164.7K	$0
David Chamberlain	MT	Internal Medicine Physician	$151.8K	$0
Nishan Dallakoti	MT	Hospitalist Physician	$118.9K	$0
Jonathan Mcneely	MT	Nephrology Physician	$103.3K	$0
Craig Treptow	MT	Family Medicine Physician	$101.5K	$230
Justin Mitchell	FL	Hospitalist Physician	$98K	$0
Thomas Frandsen	MT	Family Medicine Physician	$91.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rchp Billings - Missoula LLC	MT	Specialist	$0	$13.1M
Clark Fork Emergency Physicians PLLC	MT	Emergency Medicine Physician	$0	$6.1M
Rchp Billings - Missoula LLC	MT	General Acute Care Hospital	$0	$4M
Origin Health LLC	MT	Maternal & Fetal Medicine Physician	$0	$3.3M
Big Sky Surgery Center, LLC	MT	Ambulatory Surgical Clinic/Center	$811.5K	$954.6K
Pathology Consultants Of Western Montana, P.C.	MT	Anatomic Pathology & Clinical Pathology Physician	$0	$1.3M
Generations Family Medicine And Obstetrics	MT	Family Medicine Physician	$0	$690.8K
Rchp Billings - Missoula LLC	MT	Case Management Agency	$0	$635.1K
Kristen Townley	MT	MOHS-Micrographic Surgery Physician	$547.1K	$0
Missoula Family Medicine PLLC	MT	Family Medicine Physician	$0	$512.9K

Cogent Healthcare Of Montana P C — Billing Profile & Reimbursement Data

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Cogent Healthcare Of Montana P C — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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