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 Hospital Of Anaconda (NPI 1336244797)

Community Hospital Of Anaconda is a family medicine physician provider located in Anaconda, Montana. This profile covers 0 Medicare and 17 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	Community Hospital Of Anaconda
Address	305 W Pennsylvania Ave
City	Anaconda
State	MT
ZIP	59711
Taxonomy	Family Medicine Physician
NPI Enumerated	September 13, 2006

Payer Source	Total Paid
Medicaid	$1.1M
Medicare	$0

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

17 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…	5,340	$140	$731.2K
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…	3,150	$80	$239.6K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	1,520	$40	$65.4K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	760	$70	$49.7K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	2,190	$10	$19.7K
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…	50	$160	$8.7K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	170	$40	$6.3K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	80	$70	$5.6K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	240	$20	$4.9K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	20	$190	$3K

Showing 1–10 of 17

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 Hospital Of Anaconda — 0 of 15 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

17 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…	69	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…	137	520	730	$40	$196.4K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	1,202	1,200	750	$80	$143.2K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	47	60	380	$70	$91.2K
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…	114	160	250	$110	$85.9K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	39	50	50	$140	$61K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	38	170	310	$20	$38.7K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	79	230	300	$30	$38.1K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	122	190	60	$70	$36.9K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	17	40	630	$10	$33.8K

Showing 1–10 of 17

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Hospital Of Anaconda	MT	Pediatric Adolescent Medicine Physician	$0	$1.4M
Carmen Gota	UT	Rheumatology Physician	$1.2M	$0
Community Hospital Of Anaconda	MT	Critical Access Hospital	$0	$1.1M
Community Hospital Of Anaconda	MT	Family Medicine Physician	$0	$669.3K
Brian Bigoni	CA	Diagnostic Radiology Physician	$399.4K	$0
Karl Westenfelder	MT	Urology Physician	$286.9K	$0
Christopher Wicher	MT	Urology Physician	$251.7K	$0
Jonathan Fowlkes	MT	Otolaryngology Physician	$100.5K	$121.8K
Phillip Gardner	MT	Otolaryngology Physician	$29.9K	$179.3K
Kevin Kronner	MT	Urology Physician	$205K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aware Inc	MT	Community/Behavioral Health Agency	$0	$140.3M
Anaconda School District	MT	Local Education Agency (LEA)	$0	$1.5M
Leonard E. Vainio & David G. Vainio PC	MT	Optometrist	$0	$1.1M
Northwest Ehr Collaborative Inc.	MT	Internal Medicine Physician	$0	$982.6K
Pintler Health & Rehab, LLC	MT	Physical Therapist	$0	$614.4K
Anaconda Oxygen Service	MT	Durable Medical Equipment & Medical Supplies	$0	$542K
Lorena Craig	MT	Professional Counselor	$0	$286.2K
Jill Johnson	MT	Dental Hygienist	$0	$260.5K
Anaconda-deer Lodge County	MT	Land Ambulance	$120.1K	$124K
Montana Cvs Pharmacy LLC	MT	Pharmacy	$76.2K	$15.1K

Community Hospital Of Anaconda — Billing Profile & Reimbursement Data

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Community Hospital Of Anaconda — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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