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.

Holy Rosary Healthcare (NPI 1396074548)

Holy Rosary Healthcare is a critical access hospital provider located in Miles City, Montana. This profile covers 0 Medicare and 130 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	Holy Rosary Healthcare
Address	2600 Wilson St
City	Miles City
State	MT
ZIP	59301
Taxonomy	Critical Access Hospital
NPI Enumerated	December 17, 2009

Payer Source	Total Paid
Medicaid	$564.7K
Medicare	$0

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

130 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	7,130	$20	$142.6K
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.	4,860	$20	$72.9K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	5,350	$10	$53.5K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	3,550	$10	$46.1K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	10,570	$1	$42.3K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	2,040	$20	$36.6K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	580	$30	$17.3K
G0378	Hospital observation service, per hour	1,320	$10	$15.8K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	11,990	$1	$12K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	10,570	$1	$10.6K

Showing 1–10 of 130

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

Holy Rosary Healthcare — 0 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

130 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	23	60	2,160	$80	$526.7K
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.	28	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.	28	90	2,330	$40	$281.3K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	83	150	2,760	$40	$224.3K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	35	200	1,110	$60	$207.2K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	22	20	970	$100	$148K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	37	50	1,150	$50	$119.8K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	30	40	1,380	$20	$71K
G0378	Hospital observation service, per hour	15	30	1,610	$20	$60.4K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	30	90	490	$30	$58.3K

Showing 1–10 of 130

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Michael Groover	MT	Adult Reconstructive Orthopaedic Surgery Physician	$370.4K	$0
Jeffrey Gilroy	CO	Radiation Oncology Physician	$155K	$0
Benjamin Fischer-valuck	IL	Radiation Oncology Physician	$153.2K	$0
Michael Yorgason	MT	Orthopaedic Foot and Ankle Surgery Physician	$120.9K	$0
Jay Clark	UT	Radiation Oncology Physician	$110.5K	$0
Seth Reiner	CO	Radiation Oncology Physician	$104K	$0
George Cannon	UT	Radiation Oncology Physician	$86.2K	$0
Jaden Evans	UT	Radiation Oncology Physician	$84K	$0
Brandon Barney	UT	Radiation Oncology Physician	$82.1K	$0
Jeffrey Horn	TN	Vascular Surgery Physician	$73.6K	$240

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eastern Montana Industries	MT	Developmentally Disabled Services Day Training Agency	$0	$19.9M
Eastern Montana Community Mental Health Center	MT	Clinic/Center	$0	$13.7M
Miles City Public Schools	MT	Local Education Agency (LEA)	$0	$4.6M
Developmental Educational Assistance Program	MT	Local Education Agency (LEA)	$0	$1.4M
Eastern Mt Community Mental Health Cdu Prog	MT	Clinic/Center	$0	$956.4K
Carrie David	MT	Professional Counselor	$0	$652.1K
Yerger Family Dental, PC	MT	Dentist	$0	$570K
Miles City Vision Clinic P C	MT	Optometrist	$0	$563.3K
Pamela Colombik	MT	Mental Health Counselor	$0	$418.5K
Tabitha Williams	MT	Clinical Social Worker	$0	$406.5K

Holy Rosary Healthcare — 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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