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.

Tri-cities Community Health (NPI 1225145105)

Tri-cities Community Health is a federally qualified health center (fqhc) provider located in Pasco, Washington. This profile covers 0 Medicare and 189 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	Tri-cities Community Health
Address	515 W Court St
City	Pasco
State	WA
ZIP	99301
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	August 24, 2006

Payer Source	Total Paid
Medicaid	$13.2M
Medicare	$0

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

189 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	91,670	$40	$3.2M
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…	58,620	$50	$2.9M
T1015	Clinic visit/encounter, all-inclusive	10,980	$140	$1.5M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	10,690	$60	$630.5K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	9,390	$60	$535.3K
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…	10,070	$50	$483.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	8,540	$50	$452.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	4,960	$50	$267.8K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	16,960	$10	$237.4K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	2,930	$70	$205.1K

Showing 1–10 of 189

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

Tri-cities Community Health — 10 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

189 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	229	650	4,110	$250	$4.9M
H0004	Behavioral health counseling and therapy, per 15 minutes	117	320	2,080	$60	$495.5K
T1002	Rn services, up to 15 minutes	43	60	1,140	$100	$493.3K
96165	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of the patients’ physical health…	172	220	2,880	$50	$431K
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…	32	1,820	480	$60	$379.6K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	26	40	1,080	$70	$362.2K
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…	28	1,860	610	$40	$295.5K
H2015	Comprehensive community support services, per 15 minutes	69	140	1,820	$20	$283.8K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	73	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…	76	930	680	$60	$259.2K

Showing 1–10 of 189

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tri-cities Community Health	WA	Dentist	$0	$16.1M
Bruce Wilson	WA	Endocrinology, Diabetes & Metabolism Physician	$101K	$40.7K
Emad Abu-khieran	CA	Internal Medicine Physician	$5.6K	$0
Saul Valencia	WA	Family Medicine Physician	$3.9K	$0
Amanda Lang	MI	Optometrist	$2.2K	$190
Sonia Afshariyamchlou	WA	Endocrinology, Diabetes & Metabolism Physician	$2.3K	$0
Deepthi Rimmalapudi	CA	Endocrinology, Diabetes & Metabolism Physician	$2.2K	$0
Cheryl Hipolito	WA	Family Medicine Physician	$830	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lourdes Hospital LLC	WA	Critical Access Hospital	$0	$34M
City Of Pasco	WA	Land Ambulance	$450.5K	$12M
Thompson. Ferguson. Steinhart. James, PLLC	WA	Dentist	$0	$12.3M
Lourdes Hospital LLC	WA	Internal Medicine Physician	$0	$8.7M
House, Lee, Mast, Mcdonald And Nelson, PC	WA	Pediatric Dentistry	$0	$6.2M
Total Renal Care Inc	WA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$5.1M
Tri-cities Community Health	WA	Case Manager/Care Coordinator	$0	$4.6M
In-home Medical Inc.	WA	Durable Medical Equipment & Medical Supplies	$0	$3.3M
Sophia Chang	WA	Rheumatology Physician	$271.1K	$240
Vicki Haines	WA	Nurse Practitioner	$143.8K	$113.1K

Tri-cities Community Health — Billing Profile & Reimbursement Data

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Tri-cities Community Health — 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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