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.

Northern Montana Hospital (NPI 1427059070)

Northern Montana Hospital is a critical access hospital provider located in Havre, Montana. This profile covers 0 Medicare and 177 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	Northern Montana Hospital
Address	30 13th St
City	Havre
State	MT
ZIP	59501
Taxonomy	Critical Access Hospital
NPI Enumerated	August 4, 2005

Payer Source	Total Paid
Medicaid	$938.4K
Medicare	$0

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

177 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.	15,930	$10	$207.1K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	12,140	$10	$133.5K
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.	2,240	$30	$65K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	2,510	$20	$57.7K
G0378	Hospital observation service, per hour	2,330	$20	$48.8K
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…	8,100	$1	$32.4K
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	4,340	$10	$26.1K
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.	3,180	$10	$22.3K
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…	20,500	$1	$20.5K
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	1,370	$10	$19.1K

Showing 1–10 of 177

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

Northern Montana Hospital — 2 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

177 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.	45	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.	36	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.	18	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…	123	150	2,760	$40	$224.3K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	28	30	3,780	$40	$222.6K
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.	98	200	1,110	$60	$207.2K
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…	488	520	730	$40	$196.4K
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…	9	10	260	$180	$130.6K
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.	18	50	1,150	$50	$119.8K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	31	40	430	$70	$91.3K

Showing 1–10 of 177

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northern Montana Hospital	MT	Clinic/Center	$0	$2.3M
Belmond Community Hospital	IA	Rural Health Clinic/Center	$0	$1.9M
William Winn	MN	Diagnostic Radiology Physician	$997.1K	$0
Neil Anand	MN	Diagnostic Radiology Physician	$529.9K	$58.1K
Eric Hoyer	WY	Diagnostic Radiology Physician	$534.9K	$0
Mark Ellis	MN	Specialist	$337.9K	$0
Drew Hunter	AZ	Diagnostic Radiology Physician	$306.2K	$0
Richard Wilson	MN	Diagnostic Radiology Physician	$304.5K	$0
Nayyar Siddique	CA	Hematology & Oncology Physician	$266.6K	$0
Mark Channer	MT	Orthopaedic Surgery Physician	$226.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Havre Day Activity Center, Inc	MT	Developmentally Disabled Services Day Training Agency	$0	$16.6M
Lincare Inc.	MT	Durable Medical Equipment & Medical Supplies	$0	$1.5M
Havre Public Schools	MT	Local Education Agency (LEA)	$0	$1.3M
Wheatland Management	MT	Assisted Living Facility	$0	$978.8K
Havre Pediatric Dentistry	MT	Pediatric Dentistry	$0	$766.6K
Michele Holden	MT	Professional Counselor	$0	$760.6K
City Of Havre	MT	Land Ambulance	$197.6K	$489.3K
Bear Paw Recovery Center	MT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$638.2K
Misty Geer	MT	Mental Health Counselor	$0	$491.5K
Havre Optometric Clinic, Pllp	MT	Optometrist	$0	$339.5K

Northern Montana Hospital — Billing Profile & Reimbursement Data

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Northern Montana Hospital — 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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