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 Washington for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Washington 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. Washington (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.

South Sound Inpatient Physicians PLLC (NPI 1023285756)

South Sound Inpatient Physicians PLLC is a internal medicine physician provider located in Vancouver, Washington. This profile covers 0 Medicare and 22 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	South Sound Inpatient Physicians PLLC
Address	400 Ne Mother Joseph Pl
City	Vancouver
State	WA
ZIP	98664
Taxonomy	Internal Medicine Physician
NPI Enumerated	May 12, 2008

Payer Source	Total Paid
Medicaid	$17.6M
Medicare	$0

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	215,570	$40	$8.6M
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	61,840	$80	$4.8M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	66,260	$30	$1.9M
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	43,100	$40	$1.9M
99220	N/A	3,170	$60	$183.9K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	2,940	$60	$173.5K
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…	480	$100	$45.1K
99497	The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…	360	$20	$7.6K
99217	N/A	230	$30	$6.3K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	170	$30	$5.7K

Showing 1–10 of 22

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Washington Distribution

South Sound Inpatient Physicians PLLC — 5 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. Washington median

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	7	170	580	$30	$270.4K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	1	140	490	$40	$268.5K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	1	120	270	$90	$152K
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…	55	130	290	$90	$138.1K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	1	80	210	$50	$91K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	314	530	80	$90	$87.4K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	31	70	230	$20	$83.4K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	67	110	380	$20	$72.9K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	6	80	150	$60	$49.5K
99349	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	45	50	340	$40	$37K

Showing 1–10 of 22

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vishnu Madireddy	IL	Internal Medicine Physician	$389K	$3.1M
Sound Physicians Emergency Medicine Of Washington PLLC	WA	Emergency Medicine Physician	$0	$2.7M
Misbah Zmily	NM	Internal Medicine Physician	$609.4K	$703K
Podduturu Reddy	MI	Pulmonary Disease Physician	$1.1M	$0
Jasmit Minhas	WA	Internal Medicine Physician	$965.4K	$0
Karla Ballew	WA	Nurse Practitioner	$812.8K	$98.3K
Muneeb Malik	MD	Nephrology Physician	$362.3K	$0
Gene Quinn	AK	Cardiovascular Disease Physician	$348.3K	$0
Mark Bernardi	NV	Emergency Medicine Physician	$294.3K	$23.6K
Kevin Lee	WA	Internal Medicine Physician	$310.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Peacehealth	WA	General Acute Care Hospital	$0	$81.6M
The Vancouver Clinic Inc Ps	WA	Internal Medicine Physician	$0	$28.2M
Peacehealth	WA	Surgery Physician	$0	$13.5M
Emergency Medicine Associates PC	WA	Emergency Medicine Physician	$0	$11.1M
Rkso LLC	WA	Durable Medical Equipment & Medical Supplies	$0	$4.2M
The Vancouver Clinic Inc Ps	WA	Ambulatory Surgical Clinic/Center	$901.2K	$2.9M
Southwest Washington Regional Surgery Center, LLC	WA	Ambulatory Surgical Clinic/Center	$2.4M	$563K
Aliakbar Dadla	WA	Hematology & Oncology Physician	$613.3K	$0
Howard Nelson	WA	Diagnostic Radiology Physician	$429K	$0
David Valent	WA	Ophthalmology Physician	$333.3K	$0

South Sound Inpatient Physicians PLLC — Billing Profile & Reimbursement Data

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South Sound Inpatient Physicians PLLC — 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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