Providers
All 18 in MT
ERIC DAVID THOMAS, M.D.
NPI 1528378072, individual, Helena, MT, Internal Medicine
1
Evidence tier
documented action, then payment
- Listed on the MT Medicaid exclusion list since October 31, 2018.
- Medicaid still paid claims in 1 later month, $100 in total.
score 92 of 100, rank 447, $100 at stake
Paid after the action
Months in which Medicaid paid claims for this provider after a public action that should have triggered a screening check. This is a record of payments, not a determination that they were improper.
| list | identity check | action date | window closed | months paid after | first | last | paid after | 12 months before |
|---|---|---|---|---|---|---|---|---|
| MT Medicaid exclusion list state list extracted from https://dphhs.mt.gov/assets/excludedorterminatedmontanamedicaidproviders7.27.26.xlsx (pandas claude colmap) | Exact NPI, name verified | Oct 31, 2018 | still open | 1 | Dec 2020 | Dec 2020 | $100 | $0 |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | ERIC DAVID THOMAS, M.D. |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | October 18, 2010, last updated October 30, 2025 |
| Practice location | 601 MOUNTAIN SPRINGS RD, Helena, MT 59602-8433, 908-625-7887 |
| Specialties | Internal Medicine (207R00000X, license 12346821-1205 UT) Internal Medicine (207R00000X, license M-15839 ID) Internal Medicine (207R00000X, primary, license MED-PHYS-LIC-49958 MT) Internal Medicine (207R00000X, license 25ma08851700 NJ) Internal Medicine (207R00000X, license 55990 KY) Internal Medicine (207R00000X, license 04-45947 KS) Internal Medicine (207R00000X, license MD476250 PA) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99202 | New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more | $100 | 100% | $7.67 | $45 (top 5% from $138) | too few months to rank |
Medicare Part B 2024, largest codes
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 672 | 672 | $109K | $255 | $162 | 1.6x | 2.3x (90th percentile 4.2x) |
| 99457 | Management using the results of remote vital sign monitoring per calendar month, first 20 minutes | 1,882 | 491 | $64K | $146 | $48 | 3.0x | 2.2x (90th percentile 3.5x) |
| 99497 | Advance care planning, first 30 minutes | 874 | 873 | $63K | $150 | $80 | 1.9x | 2.3x (90th percentile 4.9x) |
| 99458 | Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes | 2,155 | 460 | $63K | $119 | $39 | 3.1x | 2.2x (90th percentile 3.5x) |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 284 | 284 | $36K | $200 | $127 | 1.6x | 2.3x (90th percentile 4.1x) |
| G0513 | Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preve | 567 | 567 | $35K | $100 | $61 | 1.6x | 2.1x (90th percentile 3.2x) |
| G0442 | Annual alcohol misuse screening, 5 to 15 minutes | 1,444 | 1,439 | $27K | $50 | $19 | 2.7x | 2.2x (90th percentile 3.8x) |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 346 | 103 | $16K | $187 | $62 | 3.0x | 1.8x (90th percentile 2.9x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
18 providers in MT carry an indicator in the public record, with $1.4M at stake between them. The most common is part of a provider network, on 12 of them, followed by more hours than a day holds on 4. 2 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | JONATHAN WILHELM Belgrade, MT, ranked 238 | $21K |
|
| 1 | TRISTAN SVEJKOVSKY Butte, MT, ranked 379 | $1K |
|
| 3 | LIVING CENTRE LIMITED Stevensville, MT, ranked 1114 | $618K |
|
| 3 | EDEN HOME HEALTH OF BOZEMAN, LLC Bozeman, MT, ranked 2580 | $0 |
|
| 3 | EDEN HOSPICE AT WESTERN MONTANA, LLC Bozeman, MT, ranked 3324 | $0 |
|
| 3 | DISCOVERY CARE CENTRE, LLC Hamilton, MT, ranked 3405 | $0 |
|
| 3 | SWEETWATER DILLON OPCO LLC Dillon, MT, ranked 3743 | $0 |
|
| 3 | SWEETWATER GF OPCO LLC Great Falls, MT, ranked 3975 | $0 |
|
Recent enforcement in MT
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJSentencedJan 17, 2025
Former nurse practitioner in Butte sentenced to five years in prison, ordered to pay more than $600,000 restitution for health care fraud
A former nurse practitioner falsely billed Blue Cross Blue Shield of Montana $62,310,000 for 158 vitamin B-12 injections that did not occur, receiving $613,108, and used another nurse practitioner's DEA registration number to write prescriptions after her own license was suspended.
DOJSentencedDec 13, 2024
Whitefish doctor sentenced for defrauding Medicare and other federal health programs
Dean was paid by a telemedicine company to sign orders for durable medical equipment that patients did not need, and he fraudulently charged Medicare, CHAMPVA and Railroad Retirement Board programs for telemedicine office visits that did not occur while also authorizing unnecessary covid tests.
DOJPleaded guiltyAug 2, 2024
Former nurse practitioner in Butte admits health care fraud; received nearly $600,000 in false claims
A former nurse practitioner prescribed controlled substances after her license was suspended, using another nurse practitioner's name and DEA registration number, and billed Blue Cross Blue Shield of Montana at least $61,995,000 for vitamin B-12 injections that did not occur, receiving at least $593,583.
DOJPleaded guiltyJul 18, 2024
Whitefish doctor admits defrauding Medicare and other federal health programs
Dean, a licensed physician, was paid by a telemedicine company to sign orders for durable medical equipment that patients did not need and then billed Medicare, CHAMPVA and the Railroad Retirement Board programs for telemedicine office visits that did not occur, resulting in more than $39 million in false billing.
DOJChargedJun 27, 2024
National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 Billion in False Claims
Dean was paid by a telemedicine company to sign orders for durable medical equipment patients did not need and fraudulently charged Medicare and other government health programs for telemedicine office visits that did not occur, resulting in over $39 million in false billing.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.