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 1215431697)

Field	Value
Entity Type	Organization
Organization	Providence Health & Services Washington
Address	4800 College St Se
City	Lacey
State	WA
ZIP	98503
Taxonomy	Clinic/Center
NPI Enumerated	March 21, 2018

Payer Source	Total Paid
Medicare	$3.3K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G9875	Nine total medicare diabetes prevention program (mdpp) core sessions were attended by an mdpp beneficiary under the mdpp expanded model (em). a core session is an mdpp service that: (1) is…	20	$110	$1.8K
G9874	Four total medicare diabetes prevention program (mdpp) core sessions were attended by an mdpp beneficiary under the mdpp expanded model (em). a core session is an mdpp service that: (1) is…	20	$60	$990
G9873	First medicare diabetes prevention program (mdpp) core session was attended by an mdpp beneficiary under the mdpp expanded model (em). a core session is an mdpp service that: (1) is furnished by an…	20	$30	$510

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Washington Distribution

Providence Health & Services Washington — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. state median

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G9875	1	10	20	$140	$2.1K
G9874	2	10	20	$90	$1.8K
G9873	2	10	20	$30	$590

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
Sea-mar Community Health Center	WA	Federally Qualified Health Center (FQHC)	$0	$8M
National Seating & Mobility, Inc.	WA	Durable Medical Equipment & Medical Supplies	$0	$5.9M
Jane Myung	WA	Ophthalmology Physician	$2.7M	$0
Vest Thurston LLC	WA	Psychiatric Hospital	$0	$2.6M
Laser & Surgery Center, LLC	WA	Ambulatory Surgical Clinic/Center	$1.5M	$4K
Penporn Reck	WA	Ophthalmology Physician	$802.6K	$0
Grant Aaker	WA	Ophthalmology Physician	$481.9K	$0
Stephen Reck	WA	Ophthalmology Physician	$433.1K	$0
Anthony Grillo	WA	Cornea and External Diseases Specialist Physician	$348.5K	$0
Crystal Adams	WA	Gynecologic Oncology Physician	$183.2K	$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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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References