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.

St. John's Lutheran Hospital, Inc. (NPI 1952312050)

St. John's Lutheran Hospital, Inc. is a critical access hospital provider located in Libby, Montana. This profile covers 0 Medicare and 172 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	St. John's Lutheran Hospital, Inc.
Address	209 Health Park Dr
City	Libby
State	MT
ZIP	59923
Taxonomy	Critical Access Hospital
NPI Enumerated	August 11, 2006

Payer Source	Total Paid
Medicaid	$1.3M
Medicare	$0

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

172 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.	9,850	$30	$275.7K
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.	12,990	$20	$220.9K
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.	4,690	$20	$103.2K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	5,060	$20	$101.2K
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…	2,630	$30	$78.8K
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…	5,470	$10	$71K
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…	3,500	$20	$62.9K
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.	1,860	$30	$46.6K
G0378	Hospital observation service, per hour	3,700	$10	$44.4K
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…	11,250	$1	$33.8K

Showing 1–10 of 172

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

St. John's Lutheran Hospital, Inc. — 0 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

172 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0481	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	3	10	770	$150	$3.3M
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.	31	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.	19	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.	22	90	2,330	$40	$281.3K
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…	95	530	580	$70	$224.6K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	48	150	2,760	$40	$224.3K
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…	29	30	3,780	$40	$222.6K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	119	200	1,110	$60	$207.2K
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…	90	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…	1,135	1,200	750	$80	$143.2K

Showing 1–10 of 172

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Zia Khan	NV	Cardiovascular Disease Physician	$732.9K	$24.7K
Nayab Zafar	NV	Interventional Cardiology Physician	$336.3K	$31.9K
Emily Hall	SD	Certified Registered Nurse Anesthetist	$81.7K	$0
Tony Lloyd	MT	Family Medicine Physician	$69.8K	$0
Kenny Wallen	MT	Certified Registered Nurse Anesthetist	$69K	$0
Frederick Pascual	WA	Pulmonary Disease Physician	$68.9K	$0
Jonathan Hayden	WY	Emergency Medical Services (Emergency Medicine) Physician	$36.5K	$0
Deborah Hoffman	MT	Sleep Medicine (Internal Medicine) Physician	$30.6K	$0
Justine Derousse	MT	Medical Physician Assistant	$19.1K	$0
Mark Alter	IL	Child & Adolescent Psychiatry Physician	$9.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Achievements, Inc.	MT	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$5.9M
Cabinet Mountain Home Care, LLC	MT	In Home Supportive Care Agency	$0	$1.9M
Libby Schools	MT	Local Education Agency (LEA)	$0	$811.7K
Lincare Inc	MT	Durable Medical Equipment & Medical Supplies	$0	$717.1K
Joan Christiansen	MT	Professional Counselor	$0	$543.7K
Family Health & Wellness, Inc.	MT	Primary Care Nurse Practitioner	$0	$364.3K
Leslie Sterling	MT	Clinical Social Worker	$11.7K	$332.4K
Office Of Randy Guinard, Lcsw LLC	MT	Clinical Social Worker	$0	$307K
Libby Volunteer Ambulance Service Inc	MT	Land Ambulance	$67.9K	$47.1K
Joel Riddel	MT	Chiropractor	$44.8K	$65.8K

St. John's Lutheran Hospital, Inc. — Billing Profile & Reimbursement Data

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St. John's Lutheran Hospital, 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

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