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.

Central Montana Medical Facilities, Inc. (NPI 1497868814)

Central Montana Medical Facilities, Inc. is a family medicine physician provider located in Lewistown, Montana. This profile covers 0 Medicare and 32 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	Central Montana Medical Facilities, Inc.
Address	408 Wendell Ave
City	Lewistown
State	MT
ZIP	59457
Taxonomy	Family Medicine Physician
NPI Enumerated	August 17, 2006

Payer Source	Total Paid
Medicaid	$741.7K
Medicare	$0

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

32 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…	4,810	$80	$385K
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…	1,290	$120	$156.1K
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…	1,640	$70	$117.9K
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…	120	$100	$11.8K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	480	$20	$10.2K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	1,000	$10	$8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	60	$120	$7.5K
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,…	140	$50	$6.9K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	210	$30	$6.7K
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.	40	$130	$5.2K

Showing 1–10 of 32

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

Central Montana Medical Facilities, Inc. — 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

32 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	71	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.	83	90	2,330	$40	$281.3K
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…	181	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…	100	520	730	$40	$196.4K
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…	358	1,200	750	$80	$143.2K
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…	51	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…	69	70	310	$90	$107.1K
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…	138	160	250	$110	$85.9K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	42	50	50	$140	$61K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	49	80	130	$80	$43.2K

Showing 1–10 of 32

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Belmond Community Hospital	IA	Rural Health Clinic/Center	$0	$1.9M
Michael Schekall	MN	Diagnostic Radiology Physician	$1.7M	$710
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
Michael Groover	MT	Adult Reconstructive Orthopaedic Surgery Physician	$370.4K	$0
Central Montana Medical Facilities, Inc	MT	Critical Access Hospital	$0	$353.7K
Mark Ellis	MN	Specialist	$337.9K	$0
Jong-ho Choi	MN	Diagnostic Radiology Physician	$326K	$0
Meghan Mckeon	MO	Diagnostic Radiology Physician	$318.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Montana Family Dentistry	MT	Dentist	$0	$1.3M
Central Mt Learning Resource Center	MT	Local Education Agency (LEA)	$0	$698.3K
Eyecare Associates Of Lewistown PC	MT	Optometrist	$0	$467.7K
Villa At Valle Vista Rehabilitation LLC	MT	Assisted Living Facility	$0	$414K
Total Family Care Pllp	MT	Family Nurse Practitioner	$0	$395.8K
Lance Eller	MT	Mental Health Counselor	$0	$326.7K
Kelli Berg	MT	Mental Health Counselor	$0	$234.2K
Central Montana Medical Facilities, Inc.	MT	Durable Medical Equipment & Medical Supplies	$0	$223.1K
Matthew Moen	MT	General Practice Dentistry	$0	$205.8K
County Of Fergus	MT	Public Health or Welfare Agency	$105.4K	$0

Central Montana Medical Facilities, Inc. — Billing Profile & Reimbursement Data

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Central Montana Medical Facilities, Inc. — 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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