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.

Rchp Billings - Missoula LLC (NPI 1376946913)

Key Findings

Field	Value
Entity Type	Organization
Organization	Rchp Billings - Missoula LLC
Address	2827 Fort Missoula Rd
City	Missoula
State	MT
ZIP	59804
Taxonomy	Specialist
NPI Enumerated	September 26, 2014

Payer Source	Total Paid
Medicaid	$13.1M
Medicare	$0

This provider is effectively single‑payer: there is no Medicare billing on file while total Medicaid revenue is $13.1M, indicating the organization’s ambulatory business is overwhelmingly Medicaid‑funded and that analyses or contracting decisions should focus on Medicaid performance and network positioning.

Revenue is highly concentrated in evaluation-and-management visits: the precomputed top 3 Medicaid codes account for 61.6% of this provider’s total Medicaid revenue, driven by 99213 ($3.9M, 31.8%), 99214 ($3.0M, 23.9%), and 99215 ($725K, 5.8%). This concentration signals that routine office visits are the primary revenue engine for the practice.

The code mix implies a broad outpatient clinic model that blends high-volume established patient care with preventive pediatric services and obstetric/maternal-fetal work: high volumes for 99213–99215 are complemented by pediatric well visits 99392, 99393, 99391 and vaccine administration codes 90460/90472, plus multiple prenatal ultrasound codes (76816, 76811, 76818, 76815). Together these codes indicate continuous ambulatory care from prenatal surveillance through childhood preventive care rather than a narrow procedure‑only specialty.

On competitive standing for core E/M services, the provider is a dominant statewide participant: 99213 ranks #5 of 523 providers in‑state (99th percentile; extreme outlier), 99214 ranks #8 of 532 (99th percentile; extreme outlier), and 99215 ranks #2 of 156 (99th percentile; extreme outlier). These rank positions show unusually high statewide volume for established office visits and market share in ambulatory evaluation-and-management.

Obstetric and prenatal imaging also show local dominance or leadership on several measures: 76818 is #1 of 3 providers in‑state (100th percentile) and 76815 is #1 of 11 providers (100th percentile), while 76816 and 76811 have high rankings (2nd and 3rd place) and percentile placements in the mid‑90s. Combined with top ranks on newborn follow-up codes 99480 and 99479 (both #1 in‑state, 100th percentile for their cohorts), the data indicate a substantive prenatal-to-newborn service line.

Preventive pediatric care and immunizations form a substantial ancillary revenue stream: 99392 ($547.7K, 4.4%) and 99393 ($421.8K, 3.4%) rank in high percentiles (96th and 99th respectively) and vaccine administration 90460 has 18.9K claims producing $416.7K (3.4%) and ranks #2 in‑state (98th percentile). High claim counts for vaccines and well‑child codes suggest the clinic captures routine pediatric visit volume in its Medicaid population.

The practice also reports meaningful outpatient diagnostic testing and infectious disease screening volumes—87635 (SARS‑CoV‑2 testing) shows 4.1K claims and $172.9K revenue and ranks in the 89th percentile—indicating operational capacity for high-throughput testing and point-of-care diagnostics alongside clinic visits. This mix supports an integrated ambulatory model that pairs visits with on-site or linked testing.

The provider has an established presence, with NPI enumeration on 2014-09-26 (~12 years ago), which is consistent with building the scale reflected in high claim volumes and top statewide rankings; tenure increases the plausibility that these high Medicaid volumes reflect sustained clinic operations rather than a short-term spike. This longevity is relevant for payers evaluating contracting, risk, or capacity in the Missoula market.

Medicaid: Complete Services Breakdown

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

119 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	59,840	$70	$3.9M
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…	34,100	$90	$3M
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…	6,470	$110	$725K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	6,020	$90	$547.7K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	4,190	$120	$485.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	3,910	$110	$421.8K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	18,940	$20	$416.7K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	5,120	$80	$409.4K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	1,940	$180	$349.6K
76818	The provider performs a biophysical profile test to measure the health of the baby during pregnancy. The test consists of a nonstress test and an ultrasound.	2,350	$130	$308.4K

Showing 1–10 of 119

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

Rchp Billings - Missoula LLC — 14 of 25 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

119 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	24	30	770	$60	$233.3K
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…	8	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…	5	520	730	$40	$196.4K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	2	20	970	$100	$148K
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…	398	1,200	750	$80	$143.2K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	3	10	260	$180	$130.6K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	5	70	420	$80	$111.7K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	4	70	310	$90	$107.1K
76818	The provider performs a biophysical profile test to measure the health of the baby during pregnancy. The test consists of a nonstress test and an ultrasound.	1	10	50	$130	$103.3K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	2	50	620	$40	$101K

Showing 1–10 of 119

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rchp Billings - Missoula LLC	MT	General Acute Care Hospital	$0	$4M
Todd Murdock	MT	Ophthalmology Physician	$103.7K	$1M
Joseph Shurtz	MT	Physical Medicine & Rehabilitation Physician	$208.4K	$89.9K
Shahid Chaudhary	MT	Nephrology Physician	$268.2K	$0
Alan Thomas	MT	Hematology & Oncology Physician	$161.1K	$0
Michelle Proper	MT	Radiation Oncology Physician	$150.7K	$0
Matthew Weiss	MT	Cardiovascular Disease Physician	$150K	$0
Brian Rah	MT	Interventional Cardiology Physician	$144.4K	$0
Sasidhar Guthikonda	PR	Interventional Cardiology Physician	$132.2K	$0
Sarah Scott	MT	Hematology & Oncology Physician	$130.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Clark Fork Emergency Physicians PLLC	MT	Emergency Medicine Physician	$0	$6.1M
Origin Health LLC	MT	Maternal & Fetal Medicine Physician	$0	$3.3M
Cogent Healthcare Of Montana P C	MT	Internal Medicine Physician	$0	$1.9M
Big Sky Surgery Center, LLC	MT	Ambulatory Surgical Clinic/Center	$811.5K	$954.6K
Pathology Consultants Of Western Montana, P.C.	MT	Anatomic Pathology & Clinical Pathology Physician	$0	$1.3M
Generations Family Medicine And Obstetrics	MT	Family Medicine Physician	$0	$690.8K
Rchp Billings - Missoula LLC	MT	Case Management Agency	$0	$635.1K
Kristen Townley	MT	MOHS-Micrographic Surgery Physician	$547.1K	$0
Missoula Family Medicine PLLC	MT	Family Medicine Physician	$0	$512.9K
Erika Hagstrom	MT	Dermatology Physician	$511K	$0

Rchp Billings - Missoula LLC — Billing Profile & Reimbursement Data

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Rchp Billings - Missoula LLC — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References