Behavioral
Providence Health & Services MT
Providence Health & Services MT was paid $5.67M by Medicaid between Jan 2018 and Dec 2024, across 58 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 36% of everything it billed.
33Billing provider infoPROVIDENCE HEALTH & SERVICES MT
MISSOULA, MT 59802
MISSOULA, MT 59802
33aNPI1215222617assigned 06/14/2011
33bProvider typeClinical Social Worker
28Total paid$5.67M
24GClaims86,982
24DCodes billed58
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Clinical Social Worker providers in Montana
Rank by total paid#3 of 347
Median peer was paid$54K
This provider vs. median105×
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 ANDERSON, DONALD 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 | 13,882 | $821K | |
| 2019 | 14,204 | $899K | |
| 2020 | 10,610 | $703K | |
| 2021 | 15,224 | $1.01M | |
| 2022 | 14,268 | $930K | |
| 2023 | 13,104 | $808K | |
| 2024incomplete | 5,690 | $500K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 36% | 23,429 | 20,928 | $2.05M |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 20% | 20,389 | 9,414 | $1.15M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 17% | 13,910 | 12,712 | $940K |
| 90792 | Psychiatric diagnostic evaluation with medical services | 6.2% | 2,413 | 2,286 | $352K |
| 99239 | Hospital discharge day management, more than 30 minutes | 4.2% | 2,496 | 2,343 | $238K |
| 99223 | Prolong inpt eval add15 m | 2.5% | 1,023 | 946 | $140K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 2.4% | 1,794 | 850 | $135K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 1.8% | 785 | 744 | $101K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | 1.2% | 1,750 | 973 | $66K |
| 99205 | Prolong outpt/office vis | <1% | 285 | 266 | $45K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | <1% | 1,030 | 570 | $41K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | <1% | 303 | 276 | $40K |
46 more codes
| J0585 | Injection, onabotulinumtoxina, 1 unit | <1% | 220 | $39K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 646 | $35K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,264 | $25K |
| 36415 | Collection of venous blood by venipuncture | <1% | 6,570 | $23K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 225 | $19K |
| 99443 | <1% | 310 | $19K | |
| 90837 | Psychotherapy session, about an hour | <1% | 233 | $16K |
| 99310 | Prolong nursin fac eval 15m | <1% | 844 | $15K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 1,053 | $15K |
| 99441 | <1% | 353 | $14K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 152 | $14K |
| 95811 | <1% | 83 | $14K | |
| 95251 | <1% | 508 | $13K | |
| 99442 | <1% | 232 | $11K | |
| 64405 | <1% | 106 | $9K | |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | <1% | 69 | $9K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 79 | $9K |
| 95886 | <1% | 74 | $9K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 1,372 | $8K |
| G0108 | Diabetes outpatient self-management training services, individual, per 30 minutes | <1% | 141 | $8K |
| 90686 | <1% | 716 | $6K | |
| 64615 | <1% | 120 | $5K | |
| 90791 | Psychiatric diagnostic evaluation | <1% | 53 | $5K |
| 94729 | <1% | 321 | $4K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 70 | $3K |
| 94726 | <1% | 222 | $3K | |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 65 | $3K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 43 | $3K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 70 | $3K |
| 95910 | <1% | 17 | $3K | |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 273 | $2K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 12 | $2K |
| 94060 | <1% | 166 | $1K | |
| 99497 | <1% | 19 | $802.53 | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 19 | $759.39 |
| G2212 | Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes) | <1% | 16 | $661.61 |
| 0124A | <1% | 17 | $520.00 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 30 | $505.80 |
| 90682 | <1% | 12 | $392.07 | |
| 99356 | <1% | 28 | $296.51 | |
| J2920 | Injection, methylprednisolone sodium succinate, up to 40 mg | <1% | 78 | $244.20 |
| 94618 | <1% | 14 | $149.46 | |
| 90656 | <1% | 12 | $127.36 | |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | 0% | 14 | $0.00 |
| J3490 | Unclassified drugs | 0% | 100 | $0.00 |
| 36416 | 0% | 334 | $0.00 |
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 officialANDERSON, DONALD (ASSISTANT SECRETARY ENROLLMENTS)
Parent organizationPROVIDENCE HEALTH & SERVICES
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.