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.

Ideal Option, PLLC (NPI 1376094961)

Field	Value
Entity Type	Organization
Organization	Ideal Option, PLLC
Address	615 W Main St
City	Cut Bank
State	MT
ZIP	59427
Taxonomy	Addiction Medicine (Family Medicine) Physician
NPI Enumerated	October 18, 2016

Payer Source	Total Paid
Medicaid	$3.6M
Medicare	$0

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0016	Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)	16,720	$130	$2.2M
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…	10,230	$100	$1M
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.	8,290	$30	$223.8K
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…	2,980	$70	$208.7K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	2,300	$10	$18.4K
Q3014	Telehealth originating site facility fee	150	$30	$3.8K
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…	10	$150	$2K

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

Ideal Option, PLLC — 1 of 7 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

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0016	Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)	1	20	3,030	$140	$643.2K
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…	35	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…	141	520	730	$40	$196.4K
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.	3	10	2,330	$30	$152.6K
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…	141	160	250	$110	$85.9K
Q3014	Telehealth originating site facility fee	36	60	350	$20	$45.9K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	17	60	420	$1	$4.5K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ideal Option, PLLC	WA	Clinic/Center	$0	$259.1M
Ideal Option, PLLC	WA	Clinical Medical Laboratory	$0	$39.2M
Ideal Option, PLLC	MD	Addiction Medicine (Family Medicine) Physician	$0	$7.4M
Ideal Option, PLLC	MT	Addiction Medicine (Family Medicine) Physician	$0	$3.3M
Crm Physicians, LLC	OR	Internal Medicine Physician	$0	$2.1M
Ideal Option, PLLC	MT	Multi-Specialty Clinic/Center	$0	$1.2M
Ideal Option, PLLC	MT	Clinic/Center	$0	$731.9K
Ideal Option, PLLC	MT	Clinic/Center	$0	$703.9K
Ideal Option, PLLC	MT	Clinic/Center	$0	$692.7K
Ideal Option, PLLC	ND	Clinic/Center	$0	$690.9K

Nearby Providers

Other providers in the same ZIP code as Ideal Option, PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mark Stanchfield	MT	Optometrist	$28.8K	$828.4K
Ideal Telemedicine Services, LLC	MT	Clinic/Center	$0	$636.3K
Northern Rockies Medical Center, Inc.	MT	Critical Access Hospital	$0	$544.2K
Northern Rockies Medical Center, Inc	MT	Ambulance	$29.8K	$496.6K
Marsha Atherton	MT	Family Medicine Physician	$4.3K	$0

Ideal Option, PLLC — Billing Profile & Reimbursement Data

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Ideal Option, PLLC — 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