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.

Kalispell Regional Medical Center Inc (NPI 1295006070)

Kalispell Regional Medical Center Inc is a neurology physician provider located in Kalispell, Montana. This profile covers 0 Medicare and 20 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	Kalispell Regional Medical Center Inc
Address	200 Commons Way Ste B&c
City	Kalispell
State	MT
ZIP	59901
Taxonomy	Neurology Physician
NPI Enumerated	January 25, 2012

Payer Source	Total Paid
Medicaid	$1.7M
Medicare	$0

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0585	Injection, onabotulinumtoxina, 1 unit	490	$900	$435K
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…	4,150	$80	$319.8K
95886	The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more…	2,740	$90	$257.1K
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…	3,660	$60	$212.5K
95911	In this procedure, the provider performs nine or ten nerve conduction studies, a diagnostic test to evaluate function, especially the electrical conduction ability of the motor and sensory nerves of…	510	$200	$102.2K
64615	The provider bilaterally administers a chemical compound to the muscles innervated by the trigeminal, facial, cervical spinal, and accessory nerves. The goal of this procedure is to paralyze the…	530	$150	$81K
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…	480	$150	$70.7K
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…	340	$140	$47.3K
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…	210	$170	$34.7K
95819	Electroencephalogram or EEG is a diagnostic test that uses small electrodes attached to the scalp to measure the electrical activity of the brain. In this procedure the provider performs the EEG…	170	$170	$28.4K

Showing 1–10 of 20

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

Kalispell Regional Medical Center Inc — 4 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. Montana median

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	66	80	2,770	$60	$471K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	76	90	2,330	$40	$281.3K
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…	85	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…	122	520	730	$40	$196.4K
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…	58	160	250	$110	$85.9K
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…	36	130	100	$120	$49.4K
J0585	Injection, onabotulinumtoxina, 1 unit	2	10	50	$120	$47.9K
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…	17	70	70	$180	$40.4K
95812	Electroencephalogram or EEG is a diagnostic test that uses small electrodes attached to the scalp to measure the electrical activity of the brain. Extended monitoring is a routine…	3	10	90	$260	$40.3K
95816	Electroencephalogram or EEG is a diagnostic test that uses small electrodes attached to the scalp to measure the electrical activity of the brain. In this procedure the provider performs the EEG…	5	10	30	$280	$40.1K

Showing 1–10 of 20

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Flathead Industries	MT	Community/Behavioral Health Agency	$0	$40.7M
A Plus Health Care Inc	MT	In Home Supportive Care Agency	$0	$28.2M
Gabriel Dawson	MT	Pediatric Dentistry	$0	$10.7M
Benefis Community Care, Inc.	MT	Case Management Agency	$0	$6.8M
Kiddsteeth PLLC	MT	Pediatric Dentistry	$0	$6.7M
Kalispell Public Schools	MT	Local Education Agency (LEA)	$0	$6M
Sunburst Community Service Foundation, Inc	MT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$5.3M
Oxytocin	MT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$4.8M
Glacier Grins Pediatric Dentistry, PLLC	MT	Dental Clinic/Center	$0	$3.8M
Kalispell Rehabilitation Associates, Inc	MT	Physical Therapist	$0	$3.6M

Kalispell Regional Medical Center Inc — Billing Profile & Reimbursement Data

Sign up for Kalispell Regional Medical Center Inc — Billing Profile & Reimbursement Data policy alerts

Kalispell Regional Medical Center Inc — Billing Profile & Reimbursement Data

Sign up for Kalispell Regional Medical Center Inc — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kalispell Regional Medical Center Inc	MT	General Acute Care Hospital	$0	$8.8M
Kalispell Regional Medical Center, Inc	MT	Clinic/Center	$0	$6.2M
Kalispell Regional Medical Center Inc	MT	Psychiatry Physician	$0	$5.9M
Kalispell Regional Medical Center Inc	MT	Emergency Medicine Physician	$0	$5.4M
Kalispell Regional Medical Center Inc	MT	Primary Care Clinic/Center	$0	$4.5M
Kalispell Regional Medical Center Inc	MT	Pediatrics Physician	$0	$3.7M
Kalispell Regional Medical Center Inc	MT	Clinic/Center	$0	$2.1M
Kalispell Regional Medical Center Inc	MT	Clinic/Center	$0	$2.1M
Kalispell Regional Medical Center, Inc	MT	Multi-Specialty Clinic/Center	$0	$1.4M
Kalispell Regional Medical Center, Inc	MT	Clinic/Center	$0	$1.3M