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.

Sunnyside Community Hospital Association (NPI 1225033814)

Key Findings

Field	Value
Entity Type	Organization
Organization	Sunnyside Community Hospital Association
Address	1016 Tacoma Ave
City	Sunnyside
State	WA
ZIP	98944
Taxonomy	Critical Access Hospital
NPI Enumerated	June 20, 2005

Payer Source	Total Paid
Medicaid	$55.1M
Medicare	$0

SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION has no Medicare billing on file and therefore operates, for the claims in this dataset, as effectively a single-payer (Medicaid) provider; total Medicaid revenue on file is $55.1M. This payer concentration means Medicaid policy and rate changes will disproportionately affect the facility’s top-line revenue.

Revenue is highly concentrated in a small set of services: the precomputed top 3 Medicaid codes account for 41.5% of the provider’s total Medicaid revenue. Those top three codes are 99284 ($5.9M, 16.7%), 99283 ($5.8M, 16.4%), and 74177 ($3M, 8.4%), indicating a small number of service lines drive a large share of dollars.

The code mix points to a predominantly emergency-department–centered operation with attached observation capacity: high-volume ED E/M codes appear at the top (99284: 18.8K claims, $313 avg paid/claim, $5.9M revenue; 99283: 33.6K claims, $172 avg paid/claim, $5.8M revenue) and observation hours are represented by G0378 (4.4K claims, $475 avg paid/claim, $2.1M revenue). This pattern is consistent with a critical access hospital serving urgent and emergent needs and routing many patients through ED/observation workflows.

Imaging and laboratory diagnostics are also material revenue drivers, supporting acute care throughput: CT abdomen/pelvis with contrast 74177 (3.9K claims, $754 avg paid/claim, $3M revenue) and CT head 70450 (3.7K claims, $403 avg paid/claim, $1.5M revenue) are in the top codes, while large volumes of basic lab panels appear (80053: 31.7K claims, $45 avg paid/claim, $1.4M revenue; 85025: 38.3K claims, $29 avg paid/claim, $1.1M revenue). These diagnostics align with ED-driven care and support the hospital’s role in acute evaluation.

State-level competitive standing is mixed and generally modest: 99283 ranks #42 of 234 providers in-state (82th percentile) indicating a stronger-than-average presence for that low-level ED E/M code, while 99284 ranks #80 of 225 (65th percentile) and 74177 ranks #55 of 139 (60th percentile), both described in the source as typical, unremarkable volume. A few areas show relatively higher state positioning for specific services—80050 ranks #12 of 93 (88th percentile) and J1439 ranks #2 of 11 (90th percentile)—but overall the hospital appears to be a solid regional participant rather than a statewide dominant center.

Service-line breadth beyond emergency care is evident but secondary: the presence of C1713 implant claims (517 claims, $1665 avg paid/claim, $860.8K revenue) plus imaging codes across extremities and chest (e.g., 73610, 71046, 73110, 73562) and rehab codes like 97110 (8.4K claims, $79 avg paid/claim, $661.4K) and speech/communication 92507 (5.5K claims, $129 avg paid/claim, $706.1K) indicate the hospital bills for surgical implants, diagnostic orthopedics, and rehabilitative services in addition to acute ED care. This mix suggests a small hospital offering a continuum from emergency stabilization to diagnostic workup and some procedural and therapy services.

Operational and financial risk considerations arise from the payer mix and revenue concentration: with $55.1M in Medicaid revenue and no Medicare billing on file, reimbursement exposure is concentrated in a single public program, and roughly 41.5% of Medicaid dollars are tied to three codes. That concentration increases sensitivity to coding or reimbursement policy changes that affect ED visits or abdominal/pelvic CT reimbursement.

SUNNYSIDE’s NPI tenure indicates it is an established provider in the community, enumerated on 2005-06-20 (~21 years ago). The long registration history supports the interpretation that these billing patterns reflect stable operational roles (ED-centric acute care with supporting diagnostics and some procedural/rehab services) rather than a transient or newly established practice profile.

Medicaid: Complete Services Breakdown

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

334 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.	18,780	$310	$5.9M
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.	33,640	$170	$5.8M
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.	3,910	$750	$3M
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.	7,650	$340	$2.6M
G0378	Hospital observation service, per hour	4,390	$480	$2.1M
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.	3,740	$400	$1.5M
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	31,690	$50	$1.4M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	9,720	$130	$1.3M
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	38,250	$30	$1.1M
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	8,190	$120	$998.6K

Showing 1–10 of 334

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

Sunnyside Community Hospital Association — 0 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

334 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	563	650	4,110	$250	$4.9M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	67	100	2,830	$80	$3.8M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	37	110	5,950	$270	$2.6M
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.	80	230	5,440	$90	$1.8M
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.	42	230	6,220	$100	$1.8M
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.	88	190	5,130	$100	$1.8M
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.	55	140	2,830	$150	$1.1M
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.	79	170	2,120	$40	$779.1K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	28	100	3,660	$100	$635.7K
96366	The provider administers an intravenous infusion or infusions of a medication for an additional hour or subsequent hours after the first hour to prevent, treat, or diagnose a condition or disease.	44	70	2,010	$210	$620.1K

Showing 1–10 of 334

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Thompson Dmd PLLC	WA	Dentist	$0	$36.6M
Total Renal Care Inc	WA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$6.1M
Swofford & Halma Clinic, Inc. P.s.	WA	Family Medicine Physician	$0	$5.4M
Mid-valley Community Clinic, PLLC	WA	Family Medicine Physician	$0	$4.4M
Thompson.ferguson.steinhart.james.leavitt,pllc	WA	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$4.2M
Sunnyside Emergency Group A Professional LLC	WA	Emergency Medicine Physician	$0	$3.8M
Derek S Weaver Do PLLC	WA	Family Medicine Physician	$0	$2.6M
B Martin And G Martin PLLC	WA	Dentist	$0	$2.6M
Greg Norell, Dds	WA	General Practice Dentistry	$0	$2.5M
City Of Sunnyside	WA	Land Ambulance	$221.9K	$672.8K

Sunnyside Community Hospital Association — Billing Profile & Reimbursement Data

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Sunnyside Community Hospital Association — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Marion Area Physicians LLC	OH	Internal Medicine Physician	$0	$15.7M
Shc Medical Center Toppenish	WA	General Acute Care Hospital	$0	$15.1M
Sunnyside Community Hospital Association	WA	Rural Health Clinic/Center	$0	$7M
Shc Medical Center - Yakima	WA	General Acute Care Hospital	$0	$6.9M
Sunnyside Community Hospital Association	WA	Rural Health Clinic/Center	$0	$5.8M
Shc Medical Center Toppenish	WA	Rural Health Clinic/Center	$0	$5M
Sunnyside Community Hospital Association	WA	Rural Health Clinic/Center	$0	$4.4M
Sunnyside Community Hospital Association	WA	Rural Health Clinic/Center	$0	$2.8M
Danko Martincic	ID	Hematology & Oncology Physician	$2.6M	$0
Belmond Community Hospital	IA	Rural Health Clinic/Center	$0	$1.9M