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.

Community Solutions Incorporated (NPI 1275182966)

Field	Value
Entity Type	Organization
Organization	Community Solutions Incorporated
Address	207 N Broadway Ste 110
City	Billings
State	MT
ZIP	59101
Taxonomy	Clinical Medical Laboratory
NPI Enumerated	September 5, 2019

Payer Source	Total Paid
Medicaid	$14.1M
Medicare	$0

Key Findings

COMMUNITY SOLUTIONS INCORPORATED operates as a high-volume clinical medical laboratory focused on definitive drug identification and alcohol breath analysis; its top revenue-driving codes are G0481 (definitive drug testing by GC/MS or LC/MS) and 82075 (breath alcohol analysis), together generating the majority of lab activity reflected in claims counts (G0481: 86.4K claims, $150 avg paid/claim; 82075: 41.9K claims, $28 avg paid/claim). The code mix and claim volumes point to a laboratory that performs large-scale toxicology and ethanol testing rather than a broad-spectrum clinical testing portfolio.

Revenue for this provider is highly concentrated: Total Medicaid revenue is $14.1M and the precomputed top-3 Medicaid codes by revenue account for 100.0% of this provider's total Medicaid revenue. Within that concentration, G0481 accounts for $13M (91.7% of this provider's total Medicaid revenue) and 82075 accounts for $1.2M (8.3% of this provider's total Medicaid revenue), indicating near-total dependence on a very small set of lab services.

Payer mix is effectively single-payer Medicaid: there is no Medicare billing on file while Medicaid revenue totals $14.1M. This means the provider’s billed activity and financial performance in the available data are driven entirely by Medicaid relationships and reimbursement dynamics rather than a mix of Medicare and Medicaid.

Competitive standing for G0481 in-state is a leading position: the provider ranks #1 of 4 providers in Montana for G0481 and sits at the 100th percentile, yet the dataset labels the volume for this code as "typical, unremarkable volume for this code." This indicates that while COMMUNITY SOLUTIONS is the top in-state biller for definitive drug testing, the observed activity level is within expected norms for a provider performing that service.

By contrast, for 82075 the provider also ranks #1 of 14 in-state and is at the 100th percentile, but the reported label is "extreme outlier, far above typical state volume for this code." The combination of 41.9K claims and $1.2M revenue for 82075 suggests an unusually large operational emphasis on breath alcohol testing relative to peers, marking this line as a true state-level outlier.

Operational implications from the code mix include a likely centralized, high-throughput testing workflow optimized for batch definitive toxicology assays and alcohol breath analysis rather than routine clinical panels. The large claim counts for G0481 (86.4K) and 82075 (41.9K) imply significant specimen throughput and instrumentation investment, and business performance will be sensitive to changes in Medicaid reimbursement rates or state testing demand for these services.

Tenure-wise, the provider’s NPI was enumerated on 2019-09-05 (~7 years ago), indicating it has been active for a relatively recent multi-year period during which it achieved substantial Medicaid volume; this suggests rapid scale-up of the specific services that dominate its billing.

From a payer or competitor perspective, COMMUNITY SOLUTIONS’ dominance on its top codes (ranked #1 and 100th percentile for both listed codes) presents both leverage and concentration risk: payers negotiating with state Medicaid programs should view this entity as a major in-state supplier for definitive drug testing and breath alcohol analysis, but also as a provider whose revenue is narrowly concentrated in a few service lines that could materially shift with policy or demand changes.

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0481	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	86,370	$150	$13M
82075	The lab analyst performs the technical lab test to analyze the quantitative amount of alcohol in a patient’s breath and correlates the measurement to blood alcohol content.	41,920	$30	$1.2M

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

Community Solutions Incorporated — 2 of 2 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

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0481	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	1	10	770	$150	$3.3M
82075	The lab analyst performs the technical lab test to analyze the quantitative amount of alcohol in a patient’s breath and correlates the measurement to blood alcohol content.	1	10	2,330	$30	$152.6K

Nearby Providers

Other providers in the same ZIP code as Community Solutions Incorporated, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Billings Clinic	MT	General Practice Physician	$0	$53.8M
Rimrock Foundation	MT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$44.9M
Scl Health Medical Group - Billings LLC	MT	Clinic/Center	$0	$32.2M
Residential Support Services	MT	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$30.6M
Billings Public School District 2	MT	Local Education Agency (LEA)	$0	$19.2M
South Central Montana Regional Mental Health Center	MT	Clinic/Center	$0	$16.6M
Billings Clinic	MT	Emergency Care Clinic/Center	$0	$15.7M
Scl Health Montana	MT	General Acute Care Hospital	$0	$13.5M
Benefis Community Care, Inc.	MT	Case Management Agency	$0	$10.8M
American Medical Response Ambulance Service Inc	MT	Ambulance	$2.1M	$6.7M

Community Solutions Incorporated — Billing Profile & Reimbursement Data

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Community Solutions Incorporated — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References