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.

St Lukes Community Hospital (NPI 1154566271)

Field	Value
Entity Type	Organization
Organization	St Lukes Community Hospital
Address	107 6th Ave Sw
City	Ronan
State	MT
ZIP	59864
Taxonomy	Urgent Care Clinic/Center
NPI Enumerated	December 3, 2008

Payer Source	Total Paid
Medicaid	$1.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

5 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…	14,140	$80	$1.2M
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…	310	$120	$35.2K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	650	$20	$9.7K
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.	400	$20	$6K
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	150	$1	$300

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

St Lukes Community Hospital — 0 of 5 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

5 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…	322	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…	36	520	730	$40	$196.4K
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.	38	100	180	$10	$5.7K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	18	80	150	$10	$4.6K
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	46	70	650	$1	$1.1K

Related Providers

Other providers that share a Tax Identification Number (TIN) with St Lukes Community Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Lukes Community Hospital	MT	Family Medicine Physician	$0	$824.3K
St Lukes Community Hospital	MT	Critical Access Hospital	$0	$714.7K
St Lukes Community Hospital	MT	Rural Health Clinic/Center	$0	$403.3K
Patrick Mcdonnell	NM	Diagnostic Radiology Physician	$142.3K	$0
Valerie Stine	MT	Diagnostic Radiology Physician	$132.8K	$0
Kara Heuvelhorst	WI	Diagnostic Radiology Physician	$131.4K	$0
Michael Henson	MT	Diagnostic Radiology Physician	$129.7K	$0
William Benedetto	MT	Diagnostic Radiology Physician	$122.4K	$0
Andrew Ziegert	WI	Diagnostic Radiology Physician	$120.9K	$0
Kelly Kieper	NM	Diagnostic Radiology Physician	$117.4K	$0

Nearby Providers

Other providers in the same ZIP code as St Lukes Community Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mission Mountain Enterprises, Inc.	MT	Developmentally Disabled Services Day Training Agency	$0	$17.9M
Ronald Dean	MT	Emergency Medicine Physician	$2.3M	$2.3K
Pal Memory Care, LLC	MT	Assisted Living Facility	$0	$1.7M
School District #30	MT	Local Education Agency (LEA)	$0	$1.4M
Western Montana Family Dentistry	MT	Dentist	$0	$1.2M
Mission Valley Eye Center, Inc.	MT	Optometrist	$0	$1.1M
Rosemary Epperson	MT	Clinical Social Worker	$0	$366.8K
Hikmat Maaliki	MT	Family Medicine Physician	$127K	$0
Marcus Simonich	MT	Optometrist	$60K	$0
Shane Hill	MT	Emergency Medicine Physician	$53.9K	$0

St Lukes Community Hospital — Billing Profile & Reimbursement Data

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St Lukes Community Hospital — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References