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.

Sam Wallace (NPI 1144353707)

Field	Value
Entity Type	Individual
Organization	Sam Wallace
Address	341 W Pine St
City	Missoula
State	MT
ZIP	59802
Taxonomy	Family Medicine Physician
NPI Enumerated	March 13, 2007

Payer Source	Total Paid
Medicare	$123.8K
Medicaid	$0

Medicare: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	820	$90	$75.8K
98928	The provider performs controlled manual pressure in seven to eight body regions to treat somatic and nonsomatic disorders.	830	$50	$43.4K
99204	The provider sees a new 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 provider…	40	$120	$4.7K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Montana Distribution

Sam Wallace — 2 of 3 codes 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

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	34	1,810	100	$70	$12.4K
98928	1	10	100	$50	$10.4K
99204	296	780	30	$100	$4.8K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Sam Wallace, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grayson Cobb	MT	Family Medicine Physician	$99.1K	$0
Elena Furrow	MT	Family Medicine Physician	$77.4K	$0
Sarah Borge	MT	Family Medicine Physician	$65.2K	$0
Matthew Anderson	MT	Family Nurse Practitioner	$62.9K	$0
Molly Quinn	MT	Physician Assistant	$55K	$0
Kevin Chin	MT	Family Medicine Physician	$46.8K	$0
Heather Harby	WA	Medical Physician Assistant	$43.4K	$0
Scott Doherty	MT	Physician Assistant	$27K	$0
Lisa Hathaway	MT	Physician Assistant	$24.4K	$0
Jason Postlethwaite	MT	Family Medicine Physician	$18.1K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Consumer Direct District Of Columbia	MT	In Home Supportive Care Agency	$0	$393.2M
Youth Homes	MT	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$9.7M
Western Montana Clinic PC	MT	Multi-Specialty Clinic/Center	$0	$8.7M
Providence Health & Services Mt	MT	Emergency Medicine Physician	$0	$8.2M
Providence Health & Services Mt	MT	Family Medicine Physician	$0	$5.7M
Providence Surgery Center	MT	Ambulatory Surgical Clinic/Center	$1.6M	$3.5M
Partnership For Children	MT	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$4.7M
Gary Wingfield	MT	Assisted Living Facility	$0	$4.7M
Providence Health & Services Mt	MT	General Acute Care Hospital	$0	$2.4M
Western Montana Clinic PC	MT	Clinical Medical Laboratory	$668.9K	$1.7M

Sam Wallace — Billing Profile & Reimbursement Data

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Sam Wallace — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References