Physician
Providence Health & Services MT
Providence Health & Services MT was paid $4.93M by Medicaid between Jan 2018 and Dec 2024, across 51 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 44% of everything it billed.
33Billing provider infoPROVIDENCE HEALTH & SERVICES MT
MISSOULA, MT 59808
MISSOULA, MT 59808
33aNPI1790931517assigned 08/12/2008
33bProvider typeFamily Medicine Physician
28Total paid$4.93M
24GClaims70,622
24DCodes billed51
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Family Medicine Physician providers in Montana
Rank by total paid#1 of 62
Median peer was paid$22K
This provider vs. median227×
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 | 13,532 | $752K | |
| 2019 | 13,050 | $728K | |
| 2020 | 8,914 | $535K | |
| 2021 | 10,439 | $820K | |
| 2022 | 10,231 | $850K | |
| 2023 | 8,680 | $703K | |
| 2024incomplete | 5,776 | $545K |
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 | 44% | 27,443 | 25,387 | $2.15M |
| 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 | 30% | 14,486 | 13,355 | $1.48M |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 9.5% | 4,420 | 4,184 | $471K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 2.5% | 2,844 | 2,566 | $123K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 2.3% | 950 | 908 | $112K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 2.2% | 2,407 | 2,324 | $109K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.6% | 656 | 641 | $80K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 1.2% | 564 | 535 | $60K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 1,580 | 1,288 | $46K |
| 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% | 293 | 269 | $44K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 2,017 | 1,960 | $40K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 3,229 | 2,630 | $38K |
39 more codes
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 663 | $37K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 659 | $37K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 144 | $21K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 842 | $17K |
| 90686 | <1% | 2,267 | $9K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 172 | $8K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 128 | $7K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 71 | $6K |
| 99205 | Prolong outpt/office vis | <1% | 32 | $6K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 134 | $5K |
| 99173 | <1% | 1,386 | $5K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 80 | $5K |
| 99384 | <1% | 20 | $3K | |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 61 | $3K |
| 99385 | <1% | 21 | $2K | |
| 99443 | <1% | 44 | $2K | |
| 90837 | Psychotherapy session, about an hour | <1% | 12 | $1K |
| 91320 | <1% | 14 | $1K | |
| 0124A | <1% | 38 | $1K | |
| 96161 | <1% | 225 | $814.90 | |
| 90461 | <1% | 1,039 | $607.81 | |
| 92552 | <1% | 18 | $551.36 | |
| 81002 | <1% | 155 | $431.51 | |
| 81003 | <1% | 250 | $419.24 | |
| 90682 | <1% | 15 | $365.88 | |
| 90480 | <1% | 16 | $360.00 | |
| 90670 | <1% | 353 | $353.46 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 19 | $338.16 |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 13 | $333.54 |
| 90656 | <1% | 90 | $177.56 | |
| 96160 | <1% | 48 | $127.38 | |
| 96127 | <1% | 13 | $103.90 | |
| 90647 | <1% | 152 | $25.06 | |
| 90685 | <1% | 157 | $18.37 | |
| 90723 | 0% | 84 | $0.00 | |
| 90680 | 0% | 44 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 12 | $0.00 |
| 90633 | 0% | 195 | $0.00 | |
| 90687 | 0% | 47 | $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 ENROLLMENT)
Parent organizationPROVIDENCE HEALTH & SERVICES
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.