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.

Wolf Point Clinic Association Inc (NPI 1992722904)

Wolf Point Clinic Association Inc is a rural health clinic/center provider located in Wolf Point, Montana. This profile covers 0 Medicare and 21 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	Wolf Point Clinic Association Inc
Address	301 Knapp St
City	Wolf Point
State	MT
ZIP	59201
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	July 16, 2006
NPI Deactivated	May 16, 2018

Payer Source	Total Paid
Medicaid	$521.1K
Medicare	$0

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

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	4,380	$40	$184.1K
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.	2,300	$80	$174.8K
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.	470	$120	$58.8K
99281	The provider sees a patient for the lowest level emergency department visit.	1,710	$20	$37.6K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	1,130	$30	$31.7K
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	110	$170	$18K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	340	$20	$6.4K
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…	80	$80	$5.8K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	30	$120	$3K
99307	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making or the…	130	$1	$500

Showing 1–10 of 21

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

Wolf Point Clinic Association Inc — 0 of 11 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

21 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	52	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.	45	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…	153	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…	43	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…	54	70	420	$80	$111.7K
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.	17	70	860	$20	$50.8K
Q3014	Telehealth originating site facility fee	37	60	350	$20	$45.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	75	80	130	$80	$43.2K
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…	135	190	130	$70	$37.2K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	39	40	560	$20	$27.4K

Showing 1–10 of 21

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Arlene Sussman	MN	Diagnostic Radiology Physician	$242.3K	$29.9K
Delphia Clarke	MN	Diagnostic Radiology Physician	$124.7K	$0
Vibhu Kapoor	MN	Diagnostic Radiology Physician	$95.7K	$0
Rebecca Dorsey	OR	Psychiatric/Mental Health Nurse Practitioner	$75.7K	$1.8K
Robert Monson	UT	Certified Registered Nurse Anesthetist	$17.3K	$0
Ian Carrese	SC	Physician Assistant	$14K	$0
Roman Hendrickson	MT	Geriatric Medicine (Family Medicine) Physician	$9.1K	$0
Haylee Thompson	MT	Family Nurse Practitioner	$1.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northeast Montana Health Services Inc	MT	Critical Access Hospital	$0	$2.2M
Myriam Greene	MT	General Practice Dentistry	$0	$553.2K

Wolf Point Clinic Association Inc — Billing Profile & Reimbursement Data

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Wolf Point Clinic Association 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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