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.

Providence St Joseph Medical Center (NPI 1669655528)

Field	Value
Entity Type	Organization
Organization	Providence St Joseph Medical Center
Address	6 13th Ave E
City	Polson
State	MT
ZIP	59860
Taxonomy	Family Medicine Physician
NPI Enumerated	December 13, 2007

Payer Source	Total Paid
Medicaid	$1.1M
Medicare	$0

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
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.	6,870	$80	$521.7K
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.	4,100	$130	$521.2K
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.	120	$180	$22.1K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	160	$10	$1.6K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	20	$70	$1.2K
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,…	20	$50	$810
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.	10	$50	$620
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	20	$20	$410

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

Providence St Joseph Medical Center — 0 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
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.	46	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.	30	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.	29	90	2,330	$40	$281.3K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	29	30	770	$60	$233.3K
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.	69	70	860	$20	$50.8K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	32	40	630	$10	$33.8K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	19	20	60	$70	$26K
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,…	213	240	170	$1	$10.3K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Providence St Joseph Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Providence St Joseph Medical Center	MT	Critical Access Hospital	$0	$654.7K
Rosemary Epperson	MT	Clinical Social Worker	$0	$366.8K
Simone Musco	MT	Clinical Cardiac Electrophysiology Physician	$318.1K	$0
Nicholas Mantini	MT	Clinical Cardiac Electrophysiology Physician	$303.9K	$0
James Maddux	MT	Interventional Cardiology Physician	$219.4K	$0
Michael Reed	MT	Cardiovascular Disease Physician	$194.7K	$0
William Hull	MT	Interventional Cardiology Physician	$180.2K	$0
Nathaniel Buffington	AK	Family Medicine Physician	$171.7K	$0
Anthony Navone	MT	Cardiovascular Disease Physician	$171.5K	$0
Alan Thomas	MT	Hematology & Oncology Physician	$161.1K	$0

Nearby Providers

Other providers in the same ZIP code as Providence St Joseph Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Polson Ambulance, Inc.	MT	Land Ambulance	$459.3K	$2.1M
Polson School District 23	MT	Local Education Agency (LEA)	$0	$1.6M
Montana Dental Group LLC	MT	General Practice Dentistry	$0	$1M
Michael Windauer	MT	General Practice Dentistry	$0	$673.1K
Kickin It Enterprises	MT	Clinical Social Worker	$0	$659.3K
Jeffrey Bird	MT	General Practice Dentistry	$0	$619.1K
Kalispell Regional Medical Center Inc	MT	Family Medicine Physician	$0	$418.9K
St Lukes Community Hospital	MT	Rural Health Clinic/Center	$0	$403.3K
Shasta Baum-strait	MT	Mental Health Counselor	$0	$360.7K
Willow Canyon Counseling Services	MT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$341.2K

Providence St Joseph Medical Center — Billing Profile & Reimbursement Data

Sign up for Providence St Joseph Medical Center — Billing Profile & Reimbursement Data policy alerts

Providence St Joseph Medical Center — Billing Profile & Reimbursement Data

Sign up for Providence St Joseph Medical Center — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References