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.

Big Horn Hospital Association (NPI 1891713533)

Big Horn Hospital Association is a critical access hospital provider located in Hardin, Montana. This profile covers 0 Medicare and 123 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	Big Horn Hospital Association
Address	17 North Miles Avenue
City	Hardin
State	MT
ZIP	59034
Taxonomy	Critical Access Hospital
NPI Enumerated	July 18, 2006

Payer Source	Total Paid
Medicaid	$1.1M
Medicare	$0

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

123 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.	17,840	$30	$606.7K
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.	4,830	$40	$173.9K
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.	10,540	$20	$158.1K
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.	2,300	$10	$20.7K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	7,170	$1	$14.3K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	720	$20	$13.6K
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	550	$20	$9.9K
99281	The provider sees a patient for the lowest level emergency department visit.	1,830	$10	$9.2K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	3,480	$1	$7K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	1,530	$1	$6.1K

Showing 1–10 of 123

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

Big Horn Hospital Association — 1 of 25 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

123 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.	27	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.	29	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.	14	90	2,330	$40	$281.3K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	33	50	1,150	$50	$119.8K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	23	40	1,380	$20	$71K
G0378	Hospital observation service, per hour	24	30	1,610	$20	$60.4K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	24	50	1,430	$20	$54.3K
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.	5	70	860	$20	$50.8K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	23	160	1,050	$10	$45.3K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	71	110	740	$10	$30.5K

Showing 1–10 of 123

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Meghan Mckeon	MO	Diagnostic Radiology Physician	$318.9K	$0
George Knight	MT	Diagnostic Radiology Physician	$141.3K	$0
John Brandon	MT	Diagnostic Radiology Physician	$126.3K	$0
Jarett Thelen	MT	Diagnostic Radiology Physician	$123.2K	$800
Zachary Bland	MT	Vascular & Interventional Radiology Physician	$118.9K	$0
Scott Paulsen	MT	Diagnostic Radiology Physician	$110.2K	$0
Tara Bowman Seitz	MT	Diagnostic Radiology Physician	$106.7K	$0
Andrew Cox	OR	Vascular & Interventional Radiology Physician	$99.9K	$0
Carl Luem	MT	Anatomic Pathology & Clinical Pathology Physician	$86.4K	$0
Eric May	MT	Diagnostic Radiology Physician	$85.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
County Of Big Horn	MT	Land Ambulance	$262.8K	$4M
Douglas Gratwohl	MT	Optometrist	$7.6K	$269.4K
Marina Rath	MT	Family Nurse Practitioner	$82.7K	$0
Gary Ostahowski	MT	Family Medicine Physician	$34.1K	$0
Jennifer Debus	MT	Family Nurse Practitioner	$590	$0

Big Horn Hospital Association — Billing Profile & Reimbursement Data

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Big Horn Hospital Association — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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