Clinic
Kalispell Regional Medical Center INC
Kalispell Regional Medical Center INC was paid $4.55M by Medicaid between Jan 2018 and Dec 2024, across 39 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 34% of everything it billed.
33Billing provider infoKALISPELL REGIONAL MEDICAL CENTER INC
KALISPELL, MT 59901
KALISPELL, MT 59901
33aNPI1013272459assigned 07/11/2012
33bProvider typePrimary Care Clinic/Center
28Total paid$4.55M
24GClaims89,976
24DCodes billed39
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Primary Care Clinic/Center providers in Montana
Rank by total paid#2 of 19
Median peer was paid$49K
This provider vs. median93×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official ABEL, KEVIN controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 17,943 | $745K | |
| 2019 | 18,583 | $859K | |
| 2020 | 13,074 | $594K | |
| 2021 | 11,678 | $614K | |
| 2022 | 10,978 | $639K | |
| 2023 | 10,564 | $644K | |
| 2024incomplete | 7,156 | $455K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 34% | 17,165 | 16,136 | $1.54M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 17% | 6,522 | 6,320 | $792K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 13% | 5,339 | 5,102 | $586K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 7.9% | 17,198 | 16,593 | $359K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 7.1% | 2,659 | 2,580 | $325K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 5.4% | 9,815 | 9,483 | $247K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 4.0% | 1,370 | 1,287 | $182K |
| 90670 | 3.4% | 4,015 | 3,884 | $153K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 2.0% | 7,654 | 7,433 | $90K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.1% | 392 | 381 | $52K |
| 90723 | <1% | 2,670 | 2,575 | $38K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 631 | 599 | $34K |
27 more codes
| 90680 | <1% | 2,175 | $33K | |
| 90474 | <1% | 2,090 | $26K | |
| 90686 | <1% | 4,580 | $24K | |
| 90647 | <1% | 2,507 | $13K | |
| 90710 | <1% | 175 | $11K | |
| 90633 | <1% | 1,037 | $9K | |
| 90677 | <1% | 240 | $7K | |
| 90651 | <1% | 33 | $4K | |
| 96127 | <1% | 416 | $3K | |
| 90685 | <1% | 518 | $3K | |
| 90716 | <1% | 58 | $3K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 138 | $2K |
| 90707 | <1% | 69 | $2K | |
| 99460 | <1% | 14 | $1K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 15 | $1K |
| 90656 | <1% | 214 | $1K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 12 | $731.38 |
| 90734 | <1% | 12 | $730.50 | |
| 90700 | <1% | 58 | $583.46 | |
| 0072A | <1% | 13 | $520.00 | |
| 90480 | <1% | 14 | $468.30 | |
| 90672 | <1% | 54 | $433.05 | |
| 90473 | <1% | 16 | $301.88 | |
| 90715 | <1% | 12 | $228.54 | |
| 90696 | <1% | 26 | $202.24 | |
| 81002 | <1% | 26 | $48.72 | |
| 96161 | <1% | 24 | $3.46 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialABEL, KEVIN (PRESIDENT)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.