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 1215189808)

Field	Value
Entity Type	Organization
Organization	Providence Health & Services - Washington
Address	1000 N Argonne Rd
City	Spokane Valley
State	WA
ZIP	99212
Taxonomy	Home Health Agency
NPI Enumerated	October 15, 2008

Payer Source	Total Paid
Medicaid	$3.7M
Medicare	$0

Medicaid: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	23,280	$70	$1.6M
G0151	Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes	21,160	$70	$1.4M
G0152	Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes	8,060	$60	$491.8K
97163	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history of a patient with three or more personal factors that may affect care, assess a clinical…	1,320	$60	$75K
97166	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of moderate analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	710	$60	$40.9K
97162	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	760	$50	$38.1K
T1030	Nursing care, in the home, by registered nurse, per diem	240	$130	$31.4K
G0300	Direct skilled nursing services of a licensed practical nurse (LPN) in the home health or hospice setting, each 15 minutes	490	$50	$24.7K
G0155	Services of clinical social worker in home health or hospice settings, each 15 minutes	120	$80	$9.7K
97167	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of high analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	100	$60	$6.3K

Showing 1–10 of 16

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 — 1 of 14 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

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1030	Nursing care, in the home, by registered nurse, per diem	15	20	530	$1,620	$2.8M
Q5001	Hospice or home health care provided in patient's home/residence	21	70	870	$160	$452.5K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	268	280	1,920	$40	$262.1K
G0151	Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes	4	60	2,650	$40	$188.7K
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	1	80	1,640	$40	$136.1K
G0300	Direct skilled nursing services of a licensed practical nurse (LPN) in the home health or hospice setting, each 15 minutes	27	40	1,070	$70	$135K
G0152	Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes	4	50	650	$40	$87K
97162	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	43	150	190	$40	$36.1K
97163	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history of a patient with three or more personal factors that may affect care, assess a clinical…	5	50	60	$40	$25K
97166	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of moderate analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	16	50	220	$40	$21.9K

Showing 1–10 of 16

Nearby Providers

Other providers in the same ZIP code as Providence Health & Services - Washington, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Geneva Woods Health Supplies Pnw, LLC	WA	Durable Medical Equipment & Medical Supplies	$0	$23.7M
Wchs Inc	WA	Methadone Clinic	$250.9K	$15.7M
Pathways Of Washington, LLC	WA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$15.8M
The Healing Lodge Of The Seven Nations	WA	Federally Qualified Health Center (FQHC)	$0	$5M
Pathways Of Washington, LLC	WA	Case Management Agency	$0	$3.5M
Parents And Children, PLLC	WA	Mental Health Counselor	$0	$2.6M
United Seating And Mobility LLC	WA	Durable Medical Equipment & Medical Supplies	$0	$2.6M
Joseph Cvancara	WA	Procedural Dermatology Physician	$571.5K	$0
Chadd Sukut	WA	MOHS-Micrographic Surgery Physician	$558.8K	$0
Mountain West Derm - Blackhart PLLC	WA	Ambulatory Surgical Clinic/Center	$407.2K	$0

Providence Health & Services - Washington — Billing Profile & Reimbursement Data

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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

Nearby Providers

Frequently Asked Questions

References