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.

Adventist Health Clearlake Hospital Inc. (NPI 1124018031)

Adventist Health Clearlake Hospital Inc. is a critical access hospital provider located in Clearlake, California. This profile covers 0 Medicare and 347 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	Adventist Health Clearlake Hospital Inc.
Address	15630 18th Ave
City	Clearlake
State	CA
ZIP	95422
Taxonomy	Critical Access Hospital
NPI Enumerated	October 24, 2005

Payer Source	Total Paid
Medicaid	$35.2M
Medicare	$0

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

347 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.	69,070	$120	$7.9M
99281	The provider sees a patient for the lowest level emergency department visit.	37,020	$110	$4.1M
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	31,770	$50	$1.5M
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.	3,940	$340	$1.3M
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	4,460	$280	$1.2M
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	3,710	$230	$868.8K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	3,880	$190	$741.3K
97750	The provider evaluates the patient’s physical performance, such as the musculoskeletal and functional capacity of the patient, through tests and activities of daily living. The provider assesses the…	7,420	$90	$675.1K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	6,370	$100	$636.6K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	4,420	$130	$592.3K

Showing 1–10 of 347

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

Adventist Health Clearlake Hospital Inc. — 4 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

347 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
0450	N/A	387	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…	101	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.	47	1,570	680	$110	$1.1M
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…	425	750	950	$50	$890K
99281	The provider sees a patient for the lowest level emergency department visit.	22	430	1,140	$90	$769.9K
81329	The lab analyst performs the technical lab test to detect deletions in the survival of motor neuron 1 (SMN1), telomeric, gene and may also analyze the survival of motor neuron 2 (SMN2), centromeric,…	47	60	400	$40	$748.5K
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)…	94	250	800	$110	$625.7K
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.	236	780	1,160	$130	$576.2K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	303	660	1,490	$30	$417.2K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	211	510	3,760	$50	$383.4K

Showing 1–10 of 347

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Adventist Health Clearlake Hospital Inc.	CA	Rural Health Clinic/Center	$0	$78.8M
Adventist Health Clearlake Hospital Inc.	CA	Rural Health Clinic/Center	$0	$74.6M
Maheep Birdi	CA	Neurology Physician	$875.8K	$0
Phillip Jones	CA	Orthopaedic Surgery Physician	$477.9K	$0
Martin Paukert	CA	Plastic and Reconstructive Surgery Physician	$472.5K	$0
Sidney Jones	CA	Orthopaedic Surgery Physician	$428K	$0
Thomas Dunlap	CA	Cardiovascular Disease Physician	$425.6K	$0
Helmuth Jones	CA	Orthopaedic Surgery Physician	$416.6K	$0
Muhammad Alim	CA	Pulmonary Disease Physician	$407.7K	$0
Ryan Moore	CA	Adult Reconstructive Orthopaedic Surgery Physician	$358.5K	$0

Adventist Health Clearlake Hospital Inc. — Billing Profile & Reimbursement Data

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Adventist Health Clearlake Hospital Inc. — 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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