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.

Nathan A Sanders Do PC (NPI 1457731705)

Field	Value
Entity Type	Organization
Organization	Nathan A Sanders Do PC
Address	3116 Saddle Dr
City	Helena
State	MT
ZIP	59601
Taxonomy	Facial Plastic Surgery Physician
NPI Enumerated	June 2, 2015

Payer Source	Total Paid
Medicaid	$269.9K
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
31231	In this procedure, the provider inserts an endoscope into the nasal cavity to examine the structures of the nasal cavity on one or both sides.	950	$170	$161.2K
99204	The provider sees a new 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 provider…	540	$130	$70K
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…	230	$110	$23.9K
99205	The provider sees a new 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 provider…	30	$220	$5.5K
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…	90	$50	$4.5K
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,…	90	$40	$3.7K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	30	$30	$900

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

Nathan A Sanders Do PC — 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
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…	339	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…	414	520	730	$40	$196.4K
31231	In this procedure, the provider inserts an endoscope into the nasal cavity to examine the structures of the nasal cavity on one or both sides.	1	10	120	$180	$60.6K
99204	The provider sees a new 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 provider…	22	130	100	$120	$49.4K
99205	The provider sees a new 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 provider…	55	70	70	$180	$40.4K
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,…	153	240	170	$1	$10.3K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	46	60	190	$10	$6K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Nathan A Sanders Do PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jamie Shafer	MT	Otolaryngic Allergy Physician	$57K	$0
Nathan Sanders	MT	Otolaryngology Physician	$55.8K	$660

Nearby Providers

Other providers in the same ZIP code as Nathan A Sanders Do PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
West Mont	MT	Adult Care Home Facility	$0	$34.7M
Intermountain Deaconess Home	MT	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$11.9M
County Of Lewis & Clark Lewis & Clark County School District #1	MT	Local Education Agency (LEA)	$0	$10.8M
Pediatric Dentistry PC	MT	Pediatric Dentistry	$0	$9.9M
Montana Children's Home & Hospital	MT	General Acute Care Hospital	$0	$8.7M
Region Iv Family Outreach, Inc	MT	Case Manager/Care Coordinator	$0	$7.3M
Lewis And Clark Emergency Physicians P C	MT	Emergency Medicine Physician	$0	$6.6M
Montana Independent Living Project	MT	In Home Supportive Care Agency	$0	$6M
St. Peter's Health	MT	Family Medicine Physician	$0	$5.2M
Edgewood Helena Senior Living LLC	MT	Assisted Living Facility	$0	$4.7M

Nathan A Sanders Do PC — Billing Profile & Reimbursement Data

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Nathan A Sanders Do PC — 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