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.

Kalispell Regional Medical Center, Inc (NPI 1568086452)

Field	Value
Entity Type	Organization
Organization	Kalispell Regional Medical Center, Inc
Address	245 Windward Way Ste 101
City	Kalispell
State	MT
ZIP	59901
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	June 5, 2020

Payer Source	Total Paid
Medicaid	$1.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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…	9,440	$90	$811.7K
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…	3,690	$70	$273.1K
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…	2,010	$60	$126.9K
98929	The provider performs controlled manual pressure in nine to ten body regions to treat somatic and nonsomatic disorders.	840	$70	$61.2K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	550	$80	$44.4K
98928	The provider performs controlled manual pressure in seven to eight body regions to treat somatic and nonsomatic disorders.	430	$70	$31.2K
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…	1,180	$20	$17.7K
96136	The provider, a physician or other qualified healthcare professional, administers two or more psychological or neuropsychological tests and scores them. Report this code for the first 30 minutes of…	530	$20	$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…	70	$160	$10.3K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	270	$10	$2.7K

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

Kalispell Regional Medical Center, Inc — 1 of 15 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…	43	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…	177	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…	159	1,200	750	$80	$143.2K
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…	144	160	250	$110	$85.9K
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…	82	130	100	$120	$49.4K
98941	The provider applies manipulation to influence joint and neurophysiological function by a variety of techniques and modalities in three to four spinal regions.	67	70	460	$40	$39.3K
98929	The provider performs controlled manual pressure in nine to ten body regions to treat somatic and nonsomatic disorders.	3	10	300	$70	$37.2K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	46	190	60	$70	$36.9K
64483	This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral).	13	20	30	$180	$28.5K
98928	The provider performs controlled manual pressure in seven to eight body regions to treat somatic and nonsomatic disorders.	2	10	250	$60	$18.6K

Showing 1–10 of 16

Related Providers

Other providers that share a Tax Identification Number (TIN) with Kalispell Regional Medical Center, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kalispell Regional Medical Center Inc	MT	General Acute Care Hospital	$0	$8.8M
Kalispell Regional Medical Center, Inc	MT	Clinic/Center	$0	$6.2M
Kalispell Regional Medical Center Inc	MT	Psychiatry Physician	$0	$5.9M
Kalispell Regional Medical Center Inc	MT	Emergency Medicine Physician	$0	$5.4M
Kalispell Regional Medical Center Inc	MT	Primary Care Clinic/Center	$0	$4.5M
Kalispell Regional Medical Center Inc	MT	Pediatrics Physician	$0	$3.7M
Kalispell Regional Medical Center Inc	MT	Clinic/Center	$0	$2.1M
Kalispell Regional Medical Center Inc	MT	Clinic/Center	$0	$2.1M
Kalispell Regional Medical Center Inc	MT	Neurology Physician	$0	$1.7M
Kalispell Regional Medical Center, Inc	MT	Clinic/Center	$0	$1.3M

Nearby Providers

Other providers in the same ZIP code as Kalispell Regional Medical Center, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Flathead Industries	MT	Community/Behavioral Health Agency	$0	$40.7M
A Plus Health Care Inc	MT	In Home Supportive Care Agency	$0	$28.2M
Gabriel Dawson	MT	Pediatric Dentistry	$0	$10.7M
Benefis Community Care, Inc.	MT	Case Management Agency	$0	$6.8M
Kiddsteeth PLLC	MT	Pediatric Dentistry	$0	$6.7M
Kalispell Public Schools	MT	Local Education Agency (LEA)	$0	$6M
Sunburst Community Service Foundation, Inc	MT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$5.3M
Oxytocin	MT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$4.8M
Glacier Grins Pediatric Dentistry, PLLC	MT	Dental Clinic/Center	$0	$3.8M
Kalispell Rehabilitation Associates, Inc	MT	Physical Therapist	$0	$3.6M

Kalispell Regional Medical Center, Inc — Billing Profile & Reimbursement Data

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Kalispell Regional Medical Center, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References