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.

Providence Health & Services Washington (NPI 1174744304)

Providence Health & Services Washington is a family medicine physician provider located in Olympia, Washington. This profile covers 0 Medicare and 141 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	Providence Health & Services Washington
Address	525 Lilly Rd Ne
City	Olympia
State	WA
ZIP	98506
Taxonomy	Family Medicine Physician
NPI Enumerated	May 2, 2007

Payer Source	Total Paid
Medicaid	$20M
Medicare	$0

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

141 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99214	The provider sees an established 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…	171,050	$50	$8.9M
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	113,900	$40	$5M
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…	36,380	$30	$1.1M
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…	14,750	$50	$708K
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…	5,290	$100	$544.7K
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…	13,160	$30	$407.8K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	12,060	$30	$337.7K
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…	3,830	$80	$321.8K
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…	3,980	$70	$294.1K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	4,010	$60	$248.3K

Showing 1–10 of 141

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

Providence Health & Services Washington — 7 of 25 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

141 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	The provider sees an established 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…	12	1,820	480	$60	$379.6K
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…	8	130	890	$100	$337.8K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	99	120	590	$230	$331.2K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	18	1,860	610	$40	$295.5K
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…	13	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…	14	140	490	$40	$268.5K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	5	120	640	$100	$259.3K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	578	930	680	$60	$259.2K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	174	590	1,280	$50	$244.5K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	74	100	390	$260	$244.5K

Showing 1–10 of 141

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Providence Health & Services Washington	WA	General Acute Care Hospital	$0	$39.9M
Jocelyn De Yao	CO	Internal Medicine Physician	$607.2K	$0
Daniel Stroupe	IL	Infectious Disease Physician	$123.1K	$318K
Yi Hsieh	WI	Urology Physician	$299K	$0
Gopal Ghimire	WA	Interventional Cardiology Physician	$274.3K	$0
Robert Wark	WA	Clinical Cardiac Electrophysiology Physician	$251K	$0
Kamal Joshi	WA	Clinical Cardiac Electrophysiology Physician	$248.1K	$0
Muhammad Khan	WA	Internal Medicine Physician	$199.4K	$0
Marina Cheng	WA	Surgery Physician	$193.3K	$0
Crystal Adams	WA	Gynecologic Oncology Physician	$183.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Behavioral Health Resources	WA	Community/Behavioral Health Agency	$0	$40.7M
Harbor Health Solutions LLC	WA	Home Health Agency	$0	$8.6M
Olympia Emergency Services, PLLC	WA	Emergency Medicine Physician	$0	$6.5M
South Sound Pediatrics PLLC	WA	Pediatrics Physician	$0	$6.3M
Healthy Future Pediatrics	WA	Pediatrics Physician	$0	$4.3M
Neighborcare Health	WA	Federally Qualified Health Center (FQHC)	$0	$3.9M
Sea Mar Community Health Centers	WA	Federally Qualified Health Center (FQHC)	$0	$3.4M
Olympia Pediatrics, PLLC	WA	Specialist	$0	$2.7M
Gastroenterology Associates, LLC	WA	Ambulatory Surgical Clinic/Center	$1.2M	$1.2M
Aaron Utterback	WA	Podiatrist	$587.6K	$0

Providence Health & Services Washington — 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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