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.

Mountain Kids Pediatrics (NPI 1982354908)

Mountain Kids Pediatrics is a pediatrics physician provider located in Missoula, Montana. This profile covers 0 Medicare and 19 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	Mountain Kids Pediatrics
Address	2825 Fort Missoula Rd Ste 201
City	Missoula
State	MT
ZIP	59804
Taxonomy	Pediatrics Physician
NPI Enumerated	March 24, 2022

Payer Source	Total Paid
Medicaid	$320.8K
Medicare	$0

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	1,230	$100	$127K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	690	$110	$78K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	930	$40	$40.8K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	260	$120	$30.5K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	1,180	$10	$15.3K
99383	The provider performs a well–patient visit for a child who is between the ages of 5 and 11 who meets the definition of new patient.	70	$120	$8.9K
99203	The provider sees a new 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 provider…	60	$120	$7.6K
99382	The provider performs a well–patient visit for a child who is between the ages of 1 and 4 who meets the definition of new patient.	50	$130	$6K
99384	The provider performs a well–patient visit for an adolescent who is between the ages of 12 and 17 who meets the definition of new patient.	10	$170	$2.2K
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	150	$10	$1.8K

Showing 1–10 of 19

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

Mountain Kids Pediatrics — 1 of 17 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

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	211	520	730	$40	$196.4K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	25	70	420	$80	$111.7K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	39	70	310	$90	$107.1K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	19	50	620	$40	$101K
99203	The provider sees a new 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 provider…	116	190	130	$70	$37.2K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	163	190	390	$10	$19.6K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	11	30	600	$10	$16.7K
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	24	50	80	$20	$16.4K
90681	This code represents a live, weakened rotavirus vaccine given by mouth in a two–dose schedule to protect against rotavirus infection.	5	10	80	$10	$5.8K
90723	The provider administers a combination inactivated vaccine intramuscularly to prevent multiple diseases, including diphtheria, tetanus, acellular pertussis, hepatitis B, and polio.	13	30	90	$10	$5.1K

Showing 1–10 of 19

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rchp Billings - Missoula LLC	MT	Specialist	$0	$13.1M
Clark Fork Emergency Physicians PLLC	MT	Emergency Medicine Physician	$0	$6.1M
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

Mountain Kids Pediatrics — Billing Profile & Reimbursement Data

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Mountain Kids Pediatrics — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References