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.

Bitterroot Family Medicine, P.C. (NPI 1083727374)

Bitterroot Family Medicine, P.C. is a primary care clinic/center provider located in Hamilton, Montana. This profile covers 0 Medicare and 22 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	Bitterroot Family Medicine, P.C.
Address	330 N 10th St
City	Hamilton
State	MT
ZIP	59840
Taxonomy	Primary Care Clinic/Center
NPI Enumerated	August 17, 2006

Payer Source	Total Paid
Medicaid	$1.4M
Medicare	$0

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	10,900	$80	$871.8K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	3,840	$90	$353.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	290	$130	$37.5K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	1,270	$20	$27.9K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	180	$110	$19.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	130	$130	$16.4K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	100	$120	$12.5K
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	1,100	$1	$4.4K
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	90	$50	$4.1K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	200	$20	$3.2K

Showing 1–10 of 22

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

Bitterroot Family Medicine, P.C. — 0 of 21 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

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	89	530	580	$70	$224.6K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	46	520	730	$40	$196.4K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	42	70	420	$80	$111.7K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	50	70	310	$90	$107.1K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	18	50	620	$40	$101K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	39	80	130	$80	$43.2K
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	27	50	80	$20	$16.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	23	110	80	$60	$13.2K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	10	20	270	$10	$10.6K
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	15	30	1,160	$1	$7.1K

Showing 1–10 of 22

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Brenda Kirkland	MT	Family Medicine Physician	$48.7K	$0
Harvard Heath	MT	Family Medicine Physician	$41K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ravalli Services Corporation	MT	Developmentally Disabled Services Day Training Agency	$0	$19.6M
Marcus Daly Memorial Hospital Corporation	MT	Critical Access Hospital	$0	$4.4M
Capron Family Dental PC	MT	General Practice Dentistry	$0	$1.5M
Beyer Big Sky Optical, Inc	MT	Optometrist	$0	$1.4M
Norco, Inc	MT	Durable Medical Equipment & Medical Supplies	$0	$859.7K
Hamilton Physical Therapy PC	MT	Physical Therapy Clinic/Center	$0	$723.6K
Therapeutic Mentoring PC	MT	Clinical Social Worker	$0	$637.7K
Teresa Maija	MT	Professional Counselor	$0	$492.2K
Health Care Providers Inc.	MT	Oxygen Equipment & Supplies (DME)	$0	$454.9K
Hamilton School District #3	MT	Local Education Agency (LEA)	$0	$391.9K

Bitterroot Family Medicine, P.C. — Billing Profile & Reimbursement Data

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Bitterroot Family Medicine, 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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