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.

Community Hospital Of Anaconda (NPI 1992838288)

Community Hospital Of Anaconda is a pediatric adolescent medicine physician provider located in Anaconda, Montana. This profile covers 0 Medicare and 26 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	Community Hospital Of Anaconda
Address	305 W Pennsylvania Ave
City	Anaconda
State	MT
ZIP	59711
Taxonomy	Pediatric Adolescent Medicine Physician
NPI Enumerated	March 14, 2007

Payer Source	Total Paid
Medicaid	$1.4M
Medicare	$0

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

26 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…	7,530	$90	$640.3K
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…	3,530	$130	$462.8K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	3,730	$20	$74.7K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	1,000	$70	$70K
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…	310	$120	$36.1K
90863	The provider prescribes and reviews medications for pharmacological management after psychotherapy services at the same encounter.	1,030	$30	$30.8K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	950	$30	$23.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	130	$120	$15.1K
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…	130	$110	$13.8K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	110	$90	$9.7K

Showing 1–10 of 26

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

Community Hospital Of Anaconda — 0 of 19 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

26 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	94	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…	65	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…	49	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…	36	70	310	$90	$107.1K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	36	50	50	$140	$61K
90863	The provider prescribes and reviews medications for pharmacological management after psychotherapy services at the same encounter.	2	10	1,660	$30	$44.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	39	80	130	$80	$43.2K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	52	170	310	$20	$38.7K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	151	230	300	$30	$38.1K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	16	190	390	$10	$19.6K

Showing 1–10 of 26

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Carmen Gota	UT	Rheumatology Physician	$1.2M	$0
Community Hospital Of Anaconda	MT	Family Medicine Physician	$0	$1.1M
Community Hospital Of Anaconda	MT	Critical Access Hospital	$0	$1.1M
Community Hospital Of Anaconda	MT	Family Medicine Physician	$0	$669.3K
Brian Bigoni	CA	Diagnostic Radiology Physician	$399.4K	$0
Karl Westenfelder	MT	Urology Physician	$286.9K	$0
Christopher Wicher	MT	Urology Physician	$251.7K	$0
Jonathan Fowlkes	MT	Otolaryngology Physician	$100.5K	$121.8K
Phillip Gardner	MT	Otolaryngology Physician	$29.9K	$179.3K
Kevin Kronner	MT	Urology Physician	$205K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aware Inc	MT	Community/Behavioral Health Agency	$0	$140.3M
Anaconda School District	MT	Local Education Agency (LEA)	$0	$1.5M
Leonard E. Vainio & David G. Vainio PC	MT	Optometrist	$0	$1.1M
Northwest Ehr Collaborative Inc.	MT	Internal Medicine Physician	$0	$982.6K
Pintler Health & Rehab, LLC	MT	Physical Therapist	$0	$614.4K
Anaconda Oxygen Service	MT	Durable Medical Equipment & Medical Supplies	$0	$542K
Lorena Craig	MT	Professional Counselor	$0	$286.2K
Jill Johnson	MT	Dental Hygienist	$0	$260.5K
Anaconda-deer Lodge County	MT	Land Ambulance	$120.1K	$124K
Montana Cvs Pharmacy LLC	MT	Pharmacy	$76.2K	$15.1K

Community Hospital Of Anaconda — Billing Profile & Reimbursement Data

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Community Hospital Of Anaconda — 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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