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.

Helena Laboratory Physicians (NPI 1518997279)

Helena Laboratory Physicians is a anatomic pathology & clinical pathology physician provider located in Helena, Montana. This profile covers 0 Medicare and 10 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	Helena Laboratory Physicians
Address	2475 E Broadway St
City	Helena
State	MT
ZIP	59601
Taxonomy	Anatomic Pathology & Clinical Pathology Physician
NPI Enumerated	July 5, 2006

Payer Source	Total Paid
Medicaid	$331.4K
Medicare	$0

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	7,020	$40	$301.9K
88307	The physician, typically a pathologist, performs a level V examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	180	$70	$11.6K
88141	The physician analyzes and interprets a cervical or vaginal cytopathology specimen, using any reporting system, such as Bethesda or non–Bethesda. This code is for the professional interpretation by…	590	$20	$8.9K
88304	The physician, typically a pathologist, performs a level III examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	600	$10	$7.2K
88342	The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,…	50	$30	$1.8K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	20	$0	$0
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	$0	$0
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	50	$0	$0
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	50	$0	$0
87624	The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result.	70	$0	$0

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

Helena Laboratory Physicians — 0 of 5 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

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	10	30	3,780	$40	$222.6K
88307	The physician, typically a pathologist, performs a level V examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	13	20	350	$80	$54.9K
88342	The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,…	16	20	670	$30	$40.4K
87624	The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result.	9	10	2,700	$10	$33K
88141	The physician analyzes and interprets a cervical or vaginal cytopathology specimen, using any reporting system, such as Bethesda or non–Bethesda. This code is for the professional interpretation by…	3	10	500	$30	$32K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	82	80	2,870	$1	$16.2K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	31	30	940	$10	$12.6K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	31	30	890	$10	$12.1K
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…	99	100	2,680	$1	$11.9K
88304	The physician, typically a pathologist, performs a level III examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	11	20	600	$10	$10.6K

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

Helena Laboratory Physicians — Billing Profile & Reimbursement Data

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Helena Laboratory Physicians — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Don Schultz	MT	Specialist	$78.7K	$0
Charles Harmon	MT	Anatomic Pathology & Clinical Pathology Physician	$73.1K	$0