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.

Pioneer Human Services (NPI 1073739207)

Field	Value
Entity Type	Organization
Organization	Pioneer Human Services
Address	1960 Thompson Drive
City	Sedro-woolley
State	WA
ZIP	98284
Taxonomy	Substance Abuse Rehabilitation Facility
NPI Enumerated	April 17, 2007

Payer Source	Total Paid
Medicaid	$6.6M
Medicare	$0

Medicaid: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	11,700	$520	$6.1M
H2036	Alcohol and/or other drug treatment program, per diem	1,510	$200	$295.8K
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	4,260	$30	$136.4K
H0043	Supported housing, per diem	1,120	$110	$124.8K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	30	$100	$3.2K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	20	$20	$440
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	30	$10	$250
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	20	$10	$120
83690	The lab analyst measures the amount of lipase enzyme in the patient specimen. Lipase is an enzyme that the pancreas secretes to help in the absorption of fat.	10	$10	$110
85610	Prothrombin time is most commonly measured using the blood plasma. Chemicals like calcium and tissue factor are added to the plasma sample and then the time is noted when the plasma clots. To analyze…	10	$0	$0

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

Pioneer Human Services — 0 of 9 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

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	26	60	8,670	$280	$4.9M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	95	100	2,830	$80	$3.8M
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	27	50	4,000	$60	$1.5M
H0043	Supported housing, per diem	88	140	1,690	$110	$602.5K
H2036	Alcohol and/or other drug treatment program, per diem	43	70	4,930	$20	$344.7K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	213	240	2,430	$10	$194.2K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	237	270	2,880	$1	$100.6K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	485	550	400	$1	$36.5K
83690	The lab analyst measures the amount of lipase enzyme in the patient specimen. Lipase is an enzyme that the pancreas secretes to help in the absorption of fat.	122	120	4,030	$1	$34K
85610	Prothrombin time is most commonly measured using the blood plasma. Chemicals like calcium and tissue factor are added to the plasma sample and then the time is noted when the plasma clots. To analyze…	130	130	2,780	$1	$12.9K

Nearby Providers

Other providers in the same ZIP code as Pioneer Human Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Peacehealth	WA	Critical Access Hospital	$0	$41.3M
Upper Skagit Indian Tribe	WA	Federally Qualified Health Center (FQHC)	$0	$4.6M
Sound Physicians Emergency Medicine Of Washington PLLC	WA	Emergency Medicine Physician	$0	$2.7M
Dan Siapco	WA	Ophthalmology Physician	$369.1K	$0
Kevin Lee	WA	Internal Medicine Physician	$310.5K	$0
Janessa Chang	WA	Physical Medicine & Rehabilitation Physician	$159.1K	$0
Herbert Stickle	WA	Family Medicine Physician	$144.2K	$0

Pioneer Human Services — Billing Profile & Reimbursement Data

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Pioneer Human Services — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References