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.

Clark Fork Emergency Physicians PLLC (NPI 1538384987)

Field	Value
Entity Type	Organization
Organization	Clark Fork Emergency Physicians PLLC
Address	2827 Fort Missoula Rd
City	Missoula
State	MT
ZIP	59804
Taxonomy	Emergency Medicine Physician
NPI Enumerated	April 13, 2007

Payer Source	Total Paid
Medicaid	$6.1M
Medicare	$0

Key Findings

CLARK FORK EMERGENCY PHYSICIANS PLLC is an emergency medicine physician group based in MISSOULA, MT with an NPI enumerated on 2007-04-13 (~19 years ago). The practice shows no Medicare billing on file and reports $6.1M in lifetime Medicaid revenue, indicating Medicaid is effectively its single public payer in the data set.

The provider’s billing mix is concentrated in emergency department evaluation and management codes: 99285, 99284, and 99283. Claims volumes and average payments reported—16.8K claims at $151 for 99285, 21.6K claims at $114 for 99284, and 17.4K claims at $63 for 99283—are consistent with an ED-focused operation that manages a broad range of acuity from low to high.

Revenue concentration is pronounced: the top three Medicaid codes are 99285, 99284, and 99283 and together the top 3 Medicaid codes by revenue account for 99.8% of this provider's total Medicaid revenue. Individually these codes account for 41.5% (99285), 40.4% (99284), and 18.0% (99283) of the provider’s Medicaid revenue, illustrating heavy dependence on a narrow set of ED E/M services.

Competitive standing within Montana is solid but not dominant: 99285 ranks #7 of 55 providers (89th percentile), 99284 ranks #8 of 75 providers (91th percentile), and 99283 ranks #15 of 88 providers (84th percentile), each labeled in the source as “typical, unremarkable volume for this code.” These ranks place the group in the upper statewide deciles for common ED E/M codes but still among many peer providers in the market.

Payment profile shows higher per-claim payment for higher-acuity visits: 99285 averages $151 paid/claim versus $114 for 99284 and $63 for 99283. Combined with the reported claim counts, this mix explains why 99285 and 99284 each contribute roughly $2.5M in revenue while 99283 contributes $1.1M, mirroring an ED patient mix with substantial moderate- and high-acuity encounters.

Ancillary or lower-revenue codes are negligible in the Medicaid mix: 93010 appears with 2.1K claims but only $8.5K revenue (0.1% of Medicaid revenue, rank #18 of 44, 60th percentile) and 99282 is functionally immaterial with 63 claims and $2.1K revenue (0.0% of Medicaid revenue, rank #61 of 70, 13th percentile). This indicates limited ancillary revenue capture outside core ED E/M services.

Because there is no Medicare billing on file, the practice’s revenue profile is effectively single-payer in the dataset (Medicaid-centric), which amplifies the business impact of reimbursement changes or policy shifts affecting Medicaid ED payments. Operationally, the group’s financial performance will be particularly sensitive to changes in reimbursement levels or utilization patterns for 99285, 99284, and 99283.

Overall, the data portray CLARK FORK EMERGENCY PHYSICIANS PLLC as an established, ED-focused provider in Montana with concentrated Medicaid revenue driven almost entirely by three E/M codes; it ranks in the upper statewide percentiles for those codes but does not show a diversified payer or service mix in the available claims data.

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	16,780	$150	$2.5M
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.	21,640	$110	$2.5M
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.	17,440	$60	$1.1M
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	2,120	$1	$8.5K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	60	$30	$2.1K

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

Clark Fork Emergency Physicians PLLC — 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

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	7	60	2,160	$80	$526.7K
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.	8	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.	15	90	2,330	$40	$281.3K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	61	70	860	$20	$50.8K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	18	40	630	$10	$33.8K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Clark Fork Emergency Physicians PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Janine Peterson-hale	MT	Emergency Medicine Physician	$28.1K	$0
Rush Twilley	AE (Armed Forces Europe)	Emergency Medicine Physician	$18.6K	$0

Nearby Providers

Other providers in the same ZIP code as Clark Fork Emergency Physicians PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rchp Billings - Missoula LLC	MT	Specialist	$0	$13.1M
Rchp Billings - Missoula LLC	MT	General Acute Care Hospital	$0	$4M
Origin Health LLC	MT	Maternal & Fetal Medicine Physician	$0	$3.3M
Cogent Healthcare Of Montana P C	MT	Internal Medicine Physician	$0	$1.9M
Big Sky Surgery Center, LLC	MT	Ambulatory Surgical Clinic/Center	$811.5K	$954.6K
Pathology Consultants Of Western Montana, P.C.	MT	Anatomic Pathology & Clinical Pathology Physician	$0	$1.3M
Generations Family Medicine And Obstetrics	MT	Family Medicine Physician	$0	$690.8K
Rchp Billings - Missoula LLC	MT	Case Management Agency	$0	$635.1K
Kristen Townley	MT	MOHS-Micrographic Surgery Physician	$547.1K	$0
Missoula Family Medicine PLLC	MT	Family Medicine Physician	$0	$512.9K

Clark Fork Emergency Physicians PLLC — Billing Profile & Reimbursement Data

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Clark Fork Emergency Physicians PLLC — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References