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.

St Peter's Medical Group North (NPI 1477844744)

St Peter's Medical Group North is a family medicine physician provider located in Helena, Montana. This profile covers 0 Medicare and 16 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	St Peter's Medical Group North
Address	3330 Ptarmigan Ln
City	Helena
State	MT
ZIP	59602
Taxonomy	Family Medicine Physician
NPI Enumerated	April 21, 2011

Payer Source	Total Paid
Medicaid	$1.5M
Medicare	$0

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	10,360	$80	$829.1K
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…	9,490	$60	$559.7K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	380	$80	$29.3K
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…	120	$150	$17.7K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	480	$30	$13K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	80	$140	$11.6K
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…	100	$100	$9.7K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	220	$20	$4.5K
99203	The provider sees a new 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 provider…	30	$90	$2.8K
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	160	$20	$2.8K

Showing 1–10 of 16

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

St Peter's Medical Group North — 0 of 14 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

16 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…	32	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…	56	520	730	$40	$196.4K
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…	99	160	250	$110	$85.9K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	18	30	470	$80	$64.1K
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…	64	130	100	$120	$49.4K
99203	The provider sees a new 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 provider…	141	190	130	$70	$37.2K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	14	20	120	$70	$24.9K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	113	190	390	$10	$19.6K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	12	30	190	$20	$11K
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	19	40	160	$20	$10.3K

Showing 1–10 of 16

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Peter's Health	MT	Family Medicine Physician	$0	$5.2M
St. Peter's Health	MT	General Acute Care Hospital	$0	$4.2M
St Peters Community Hospital	MT	Multi-Specialty Clinic/Center	$0	$2.6M
St. Peter's Hospital	MT	Ambulance	$0	$1.6M
St. Peter's Health	MT	Oxygen Equipment & Supplies (DME)	$0	$1.4M
Sheila Manhas	CA	Neurology Physician	$1.4M	$0
St. Peter's Health	MT	Radiology Clinic/Center	$13.3K	$849.9K
St. Peter's Health	MT	Radiology Clinic/Center	$1.3K	$623.3K
Mohammed Jaloudi	RI	Medical Oncology Physician	$398.2K	$0
James Tarver	MT	Diagnostic Radiology Physician	$262.4K	$300

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Spring Meadow Resources, Inc.	MT	Developmentally Disabled Services Day Training Agency	$0	$20.2M
Intermountain Deaconess Home For Children	MT	Psychologist	$0	$1.7M
Masonic Home Of Montana, Inc.	MT	Assisted Living Facility	$0	$1.5M
Roots Rehab	MT	Occupational Therapist	$0	$1.3M
Montana Kids Dental LLC	MT	Pediatric Dentistry	$0	$1.3M
First Words Speech And Language Clinic	MT	Speech-Language Pathologist	$0	$845.3K
Lincare Inc.	MT	Durable Medical Equipment & Medical Supplies	$0	$836.8K
Intermountain Sbs	MT	Community/Behavioral Health Agency	$0	$606.1K
Montana Telepsych Solutions Inc.	MT	Psychiatric/Mental Health Nurse Practitioner	$0	$440.6K
Eric Thomas	MT	Internal Medicine Physician	$379.7K	$0

St Peter's Medical Group North — Billing Profile & Reimbursement Data

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St Peter's Medical Group North — 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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