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.

Capital Opportunties, Inc. (NPI 1518085851)

Field	Value
Entity Type	Organization
Organization	Capital Opportunties, Inc.
Address	82 8th St
City	Belgrade
State	MT
ZIP	59714
Taxonomy	Nursing Care Agency
NPI Enumerated	March 26, 2007

Payer Source	Total Paid
Medicaid	$38.1M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and therefore operates effectively as a Medicaid-focused entity; reported lifetime Medicaid revenue is $38.1M with no parallel Medicare scale to compare against. The absence of Medicare activity indicates payer concentration risk is heavily skewed to state Medicaid programs rather than federal fee-for-service Medicare.

Revenue is extremely concentrated among a small set of Medicaid codes: the top three codes (T1019, S5126, T2001) account for 97.5% of the provider’s total Medicaid revenue. The largest driver is T1019, which alone represents $34.1M or 89.4% of Medicaid revenue, followed by S5126 at $2.1M (5.5%) and T2001 at $950.8K (2.5%), indicating most revenue depends on personal-care and attendant services.

The code mix (dominance of T1019 — Personal care services per 15 minutes — plus S5126 attendant care per diem and T2001 patient attendant/escort transportation) signals that the organization operates primarily as a community-based personal care and attendant services agency with substantial non-emergency transport support. Ancillary codes such as S5130 (homemaker services) and A0080 (volunteer vehicle miles) further reinforce a home- and community-based service model rather than clinical/skilled nursing care.

In statewide competitive standing, the provider is a major participant for several key codes: T1019 ranks #2 of 38 providers in-state (97th percentile) and is described as notably above typical state volume, signaling near-top scale in personal care. S5126 and T2001 also rank #2 in their respective peer sets (93th and 91th percentiles), while S5130 and A0080 are ranked #1 of in-state peers (100th percentile) and explicitly noted as notably above typical state volume, indicating leadership in homemaker services and volunteer-mile transportation.

Operational throughput is large for Medicaid personal care and transport: T1019 shows 696K claims at an average paid/claim of $49, S5126 shows 84.3K claims at $25 avg paid/claim, and A0080 reports 61.2K claims at $5 avg paid/claim. These high claim counts for time-based and mileage-based services imply a labor- and logistics-heavy operation with significant recurring unit activity rather than episodic high-dollar procedures.

Per-unit economics vary across the main service lines: T1019’s $49 avg paid/claim combined with very high claim volume generates the vast majority of revenue, while T2001’s $71 avg paid/claim contributes meaningfully despite lower claim counts. S5126’s per-diem reimbursement ($25 avg paid/claim) and S5130’s $22 avg paid/claim reflect lower per-unit rates but substantial aggregate revenue when delivered at scale; these different rate structures point to mixed margins across service lines.

Not all reported codes show the same market prominence: several transport and homemaker codes are notable outliers in state rankings (S5130 and A0080 at 100th percentile; S0215 at 95th percentile), while some clinical or rehabilitative codes (e.g., H2019) appear at low relative volumes (H2019 ranks #28 of 36, 23th percentile) and contribute negligibly to revenue. This contrast suggests the provider’s competitive advantage is concentrated in non-clinical home- and community-based supports rather than behavioral health or skilled clinical services.

The provider has been enumerated since 2007-03-26 (~19 years), indicating an established operational history in the state Medicaid market. Combined with the high concentration in a few Medicaid codes and top-tier in-state rankings for several non-clinical services, the tenure supports a durable, specialized business profile focused on personal care, attendant services, and transportation rather than diversified payer mix or Medicare-based services.

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	695,970	$50	$34.1M
S5126	Attendant care services; per diem	84,290	$30	$2.1M
T2001	Non-emergency transportation; patient attendant/escort	13,390	$70	$950.8K
S5130	Homemaker service, nos; per 15 minutes	23,030	$20	$506.7K
A0080	Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest	61,220	$10	$306.1K
T1003	Lpn/lvn services, up to 15 minutes	1,940	$30	$64.2K
S0215	Non-emergency transportation; mileage, per mile	14,850	$1	$59.4K
H2019	Therapeutic behavioral services, per 15 minutes	640	$50	$32K

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

Capital Opportunties, Inc. — 4 of 8 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

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5126	Attendant care services; per diem	2	20	5,400	$100	$111M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	2	40	6,240	$130	$14.6M
T1003	Lpn/lvn services, up to 15 minutes	4	10	1,570	$170	$823K
H2019	Therapeutic behavioral services, per 15 minutes	28	40	3,280	$50	$759.9K
T2001	Non-emergency transportation; patient attendant/escort	2	10	1,730	$50	$264.4K
S5130	Homemaker service, nos; per 15 minutes	1	10	1,560	$30	$143.8K
A0080	Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest	1	10	2,890	$10	$70.6K
S0215	Non-emergency transportation; mileage, per mile	2	20	1,250	$10	$41.3K

Nearby Providers

Other providers in the same ZIP code as Capital Opportunties, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mosaic, Inc	MT	Clinic/Center	$0	$3.6M
Peak Health & Wellness, LLC	MT	Urgent Care Clinic/Center	$0	$3.6M
Belgrade Public Schools	MT	Local Education Agency (LEA)	$0	$2.3M
Lisa Collins	MT	Mental Health Counselor	$0	$552.4K
Central Valley Fire District	MT	Land Ambulance	$146.5K	$133.6K
Belgrade Family Dental, P.C.	MT	Dentist	$0	$264.1K
Michele Violi	MT	Clinical Social Worker	$0	$250.3K
David Hardy	MT	Mental Health Counselor	$0	$215.3K
Tessa Slominski	MT	Clinical Social Worker	$0	$212.7K
Joseph Parks	MT	Optometrist	$10.9K	$144.8K

Capital Opportunties, Inc. — Billing Profile & Reimbursement Data

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Capital Opportunties, Inc. — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References