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.

Rebecca Danforth (NPI 1164570172)

Field	Value
Entity Type	Individual
Organization	Rebecca Danforth
Address	500 W Broadway St
City	Missoula
State	MT
ZIP	59802
Taxonomy	Rheumatology Physician
NPI Enumerated	January 8, 2007

Payer Source	Total Paid
Medicare	$396K
Medicaid	$0

Key Findings

REBECCA DANFORTH is effectively a single-payer Medicare provider with $396K in total Medicare revenue and no Medicaid billing on file, so analyses of payer mix should treat this profile as Medicare-dominant rather than balanced across payers. The lack of any Medicaid codes means there is no in-state Medicaid footprint to assess for competitive standing or service mix.

Revenue is heavily concentrated in a small set of biologic drug administration codes: the precomputed top 3 Medicare codes account for 75.0% of this provider's total Medicare revenue, indicating the practice’s income is dominated by high-cost infused or injected biologic therapies rather than office visit volume. This concentration implies the business model centers on in-office biologic administration and associated infusion services.

The single largest revenue driver is J3262 (tocilizumab) with $115.4K in revenue, representing 28.7% of total Medicare revenue; J0129 (abatacept) and J1602 (golimumab) together with J3262 form the three-code concentration noted above. These codes and their descriptions point to routine use of specialty immunomodulatory medications typical for a rheumatology practice managing inflammatory and autoimmune conditions.

Clinical service mix shows a secondary but meaningful role for evaluation-and-management visits: 99214 and 99215 together account for $29.8K and $21.6K respectively, reflecting ongoing management of established patients at moderate-to-high complexity. However, E/M revenue is substantially smaller than biologic drug revenue, reinforcing that infusion/injection drug administration is the core revenue stream.

On national competitive standing for Medicare drug codes, this provider generally ranks in lower-to-middle percentiles: J3262 ranks at the 24th percentile, J0129 at the 11th percentile, and J1602 at the 28th percentile, which indicates modest, typical volumes for these drugs rather than domination of national markets. These percentiles suggest the provider is a modest participant in biologic administration relative to peers rather than a regional or national high-volume center.

Tenure on the Medicare roster is long: the NPI was enumerated on 2007-01-08 (approximately 19 years ago), indicating sustained participation in Medicare and an established practice presence in Missoula, MT. This longevity supports interpretation of the billing mix as a mature, steady-state pattern rather than a short-term anomaly.

Procedure-level utilization beyond biologics is limited but present: infusion administration codes such as 96365, 96375 and chemotherapy/infusion-related codes (96413, 96415) appear at low volumes and low revenue shares, suggesting occasional longer infusion sessions or add-on infusion services but not a dominant oncology infusion practice. These lower-volume infusion and chemo codes rank at modest-to-low national percentiles, consistent with sporadic rather than core service lines.

Medicare: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J3262	Injection, tocilizumab, 1 mg	23,080	$10	$115.4K
J0129	Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	2,900	$30	$98.6K
J1602	Injection, golimumab, 1 mg, for intravenous use	8,730	$10	$87.3K
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…	340	$90	$29.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	170	$120	$21.6K
J0897	Injection, denosumab, 1 mg	1,080	$20	$19.4K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	60	$150	$8.6K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	160	$50	$8.3K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	30	$100	$3.1K
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…	30	$110	$3K

Showing 1–10 of 19

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Montana Distribution

Rebecca Danforth — 0 of 19 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

19 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J1602	5	10	17,870	$10	$287.4K
J3262	5	10	51,720	$1	$272.3K
J0129	5	10	6,880	$30	$252.9K
J0897	10	10	1,200	$20	$27.2K
99214	268	1,810	100	$70	$12.4K
96413	8	10	60	$100	$11.3K
99215	82	780	40	$100	$7.9K
90662	162	180	70	$70	$7.9K
96365	5	20	70	$50	$7.8K
99213	1,721	1,730	90	$50	$7.2K

Showing 1–10 of 19

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
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 Health & Services Mt	MT	Family Medicine Physician	$0	$4.9M
Scott Guess	MT	Ophthalmology Physician	$2.7M	$72.4K
Francisco Rodriguez	FL	Medical Oncology Physician	$2.7M	$0
Providence Health & Services Mt	MT	General Acute Care Hospital	$0	$2.4M
Western Montana Clinic PC	MT	Clinical Medical Laboratory	$668.9K	$1.7M
Melody Nelsen	MT	Rheumatology Physician	$2M	$0
Providence Health & Services Mt	MT	Psychiatric/Mental Health Nurse Practitioner	$0	$1.8M

Nearby Providers

Other providers in the same ZIP code as Rebecca Danforth, 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
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
Rebecca Belsom	MT	Rheumatology Physician	$1.4M	$0
Blue Mountain Clinic, Inc.	MT	Family Medicine Physician	$0	$1.4M
Youth Homes	MT	Community/Behavioral Health Agency	$0	$972.2K
Partnership For Children	MT	Community/Behavioral Health Agency	$0	$937.8K
County Of Missoula	MT	Public Health or Welfare Agency	$81.3K	$657.1K

Rebecca Danforth — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References