Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or California for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to California only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. California (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Kaiser Foundation Hospitals (NPI 1013062769)

Kaiser Foundation Hospitals is a general acute care hospital provider located in San Diego, California. This profile covers 0 Medicare and 438 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Kaiser Foundation Hospitals
Address	9455 Clairemont Mesa Blvd
City	San Diego
State	CA
ZIP	92123
Taxonomy	General Acute Care Hospital
NPI Enumerated	January 24, 2007

Payer Source	Total Paid
Medicaid	$93.1M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

438 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	89,450	$400	$36M
G0378	Hospital observation service, per hour	11,610	$630	$7.3M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	12,130	$590	$7.1M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	10,070	$270	$2.7M
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	2,850	$930	$2.6M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	8,280	$240	$2M
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	600	$2,800	$1.7M
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	28,800	$40	$1.2M
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	1,920	$560	$1.1M
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	3,250	$310	$1M

Showing 1–10 of 438

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other California providers billing the same CPT/HCPCS codes.

Claims Volume vs. California Distribution

Kaiser Foundation Hospitals — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. California median

438 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
81420	The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,…	24	30	300	$260	$18M
0450	N/A	235	450	16,140	$90	$3.6M
81220	The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR…	28	110	190	$140	$1.6M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	26	1,570	680	$110	$1.1M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	853	1,300	510	$100	$943K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	266	750	950	$50	$890K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	267	1,400	470	$80	$884.5K
99281	The provider sees a patient for the lowest level emergency department visit.	152	430	1,140	$90	$769.9K
78815	PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.…	60	230	270	$840	$717.2K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	114	250	800	$110	$625.7K

Showing 1–10 of 438

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sharp Memorial Hospital	CA	General Acute Care Hospital	$0	$133.7M
Rady Children's Hospital San Diego	CA	Pediatrics Physician	$0	$77.3M
American Medical Response Ambulance Service Inc	CA	Ambulance	$9.6M	$65.4M
Rady Children's Hospital San Diego	CA	Children's Hospital	$0	$69.1M
Serene Health	CA	Mental Health Counselor	$0	$60.5M
Rac & Associates, Inc.	CA	Durable Medical Equipment & Medical Supplies	$0	$58.2M
Anesthesia Service Medical Group	CA	Anesthesiology Physician	$0	$31M
Balboa Nephrology Medical Group, Inc.	CA	Nephrology Physician	$0	$25.9M
Centro De Salud De La Comunidad De San Ysidro, Inc.	CA	Dental Clinic/Center	$0	$22.3M
Atul Jain	CA	Ophthalmology Physician	$3.5M	$0

Kaiser Foundation Hospitals — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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References