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

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

Washington University (NPI 1194765685)

Washington University is a multi-specialty clinic/center provider located in Saint Louis, Missouri. This profile covers 0 Medicare and 90 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	Washington University
Address	1 Childrens Pl
City	Saint Louis
State	MO
ZIP	63110
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	June 7, 2006

Payer Source	Total Paid
Medicaid	$22M
Medicare	$0

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

90 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	34,060	$150	$5.1M
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.	44,570	$110	$4.7M
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.	12,010	$200	$2.4M
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…	14,540	$80	$1.2M
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	6,090	$140	$864.1K
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…	10,390	$80	$852K
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…	3,740	$190	$710.4K
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…	5,070	$120	$608.9K
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…	1,660	$250	$415.4K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	2,130	$190	$404.1K

Showing 1–10 of 90

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

Washington University — 16 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

90 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	34	600	140	$170	$384.1K
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.	11	950	120	$150	$288.2K
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.	10	1,260	220	$120	$242.4K
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	2	40	100	$330	$144.9K
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.	66	90	120	$250	$141.3K
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	18	50	150	$440	$131.7K
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…	72	3,170	230	$70	$128.1K
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…	138	590	260	$40	$120.5K
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	2	50	220	$120	$114.7K
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…	412	4,310	300	$60	$110.8K

Showing 1–10 of 90

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Washington University	MO	Multi-Specialty Clinic/Center	$0	$14.8M
Washington University	MO	Multi-Specialty Clinic/Center	$0	$10.4M
Washington University	MO	Emergency Care Clinic/Center	$0	$9.1M
Washington University	MO	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$6.9M
Washington University	MO	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.4M
Washington University	MO	Multi-Specialty Clinic/Center	$0	$4M
John Visconti	IL	Medical Oncology Physician	$2.8M	$149.1K
Peter Oppelt	MO	Medical Oncology Physician	$2.5M	$15.8K
Ronald Dean	MT	Emergency Medicine Physician	$2.3M	$2.3K
Rama Suresh	MO	Medical Oncology Physician	$2.1M	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Council For Extended Care	MO	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$98.1M
St. Louis Children's Hospital	MO	Children's Hospital	$0	$66.9M
Barnes Jewish Hospital	MO	General Acute Care Hospital	$0	$61.4M
Paraquad Inc	MO	Customized Equipment (DME)	$0	$56.3M
Cooperative Home Care, Inc.	MO	Home Health Agency	$0	$20.6M
New Beginnings In Home Services, LLC	MO	In Home Supportive Care Agency	$0	$11.6M
Bjc Home Care Services	MO	Durable Medical Equipment & Medical Supplies	$0	$8.2M
Wallace Family In Home Health LLC	MO	In Home Supportive Care Agency	$0	$6.6M
Cooperative Home Care	MO	Home Health Agency	$0	$5.5M
Josephines Caring Hands	MO	In Home Supportive Care Agency	$0	$3.4M

Washington University — Billing Profile & Reimbursement Data

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Washington University — 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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