Clinic
Kalispell Regional Medical Center INC
Kalispell Regional Medical Center INC was paid $2.11M by Medicaid between Jan 2018 and May 2021, across 37 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 66% of everything it billed.
33Billing provider infoKALISPELL REGIONAL MEDICAL CENTER INC
KALISPELL, MT 59901
KALISPELL, MT 59901
33aNPI1538476767assigned 09/09/2010
33bProvider typeUrgent Care Clinic/Center
28Total paid$2.11M
24GClaims41,542
24DCodes billed37
24AFirst – last monthJan 2018 – May 2021
Compared with peers
Next to other Urgent Care Clinic/Center providers in Montana
Rank by total paid#1 of 6
Median peer was paid$512K
This provider vs. median4.1×
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 LAMBRECHT, CRAIG controls 14+ 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 | 18,395 | $778K | |
| 2019 | 12,960 | $731K | |
| 2020 | 7,732 | $451K | |
| 2021 | 2,455 | $147K |
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 | 66% | 21,645 | 20,035 | $1.39M |
| 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 | 19% | 4,698 | 4,269 | $396K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 3.1% | 2,999 | 2,848 | $64K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 2.0% | 1,070 | 1,007 | $43K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.6% | 2,288 | 2,082 | $34K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.2% | 225 | 202 | $25K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.1% | 211 | 178 | $23K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 158 | 153 | $19K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 729 | 705 | $18K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 134 | 131 | $15K |
| S0281 | Medical home program, comprehensive care coordination and planning, maintenance of plan | <1% | 3,178 | 3,178 | $13K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 102 | 96 | $10K |
25 more codes
| 90686 | <1% | 866 | $8K | |
| 87631 | <1% | 73 | $8K | |
| 90837 | Psychotherapy session, about an hour | <1% | 84 | $7K |
| 80053 | Comprehensive metabolic panel | <1% | 180 | $6K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 230 | $5K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 241 | $4K |
| 36415 | Collection of venous blood by venipuncture | <1% | 1,507 | $4K |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 93 | $3K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 58 | $3K |
| 90670 | <1% | 41 | $1K | |
| 90734 | <1% | 12 | $1K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 245 | $1K |
| 90651 | <1% | 15 | $656.07 | |
| 84439 | <1% | 59 | $593.37 | |
| S0315 | Disease management program; initial assessment and initiation of the program | <1% | 62 | $465.00 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 38 | $399.23 |
| 99173 | <1% | 117 | $377.81 | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 64 | $346.46 |
| 83735 | <1% | 41 | $282.72 | |
| 93000 | <1% | 14 | $268.80 | |
| 90647 | <1% | 13 | $100.24 | |
| 90685 | <1% | 13 | $73.48 | |
| 86140 | <1% | 15 | $62.57 | |
| 81003 | <1% | 12 | $24.75 | |
| 90723 | 0% | 12 | $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 officialLAMBRECHT, CRAIG (PRESIDENT/CHIEF EXECUTIVE OFFICER)
| Provider | Location | Paid |
|---|---|---|
| Kalispell Regional Medical Center INC | Kalispell, MT | $2.07M |
| Kalispell Regional Medical Center INC | Polson, MT | $419K |
| Northwest Orthopedics and Sports Medicine LLC | Kalispell, MT | $317K |
| Kalispell Regional Medical Center INC | Kalispell, MT | $297K |
| Kalispell Regional Medical Center INC | Kalispell, MT | $179K |
| Kalispell Regional Medical Center INC | Kalispell, MT | $157K |
| Kalispell Regional Medical Center INC | Bigfork, MT | $126K |
| Kalispell Regional Medical Center INC | Lakeside, MT | $113K |
| Kalispell Regional Medical Center INC | Kalispell, MT | $108K |
| Kalispell Regional Medical Center INC | Kalispell, MT | $85K |
| Kalispell Regional Medical Center INC | Kalispell, MT | $15K |
| Kalispell Regional Medical Center INC | Libby, MT | $11K |
| Kalispell Regional Medical Center INC | Kalispell, MT | $5K |
| Kalispell Regional Medical Center, INC. | Kalispell, MT | $4K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.