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 1225289895)

Field	Value
Entity Type	Organization
Organization	Providence Health & Services - Washington
Address	5633 N Lidgerwood St
City	Spokane
State	WA
ZIP	99208
Taxonomy	General Acute Care Hospital
NPI Enumerated	October 1, 2008

Payer Source	Total Paid
Medicaid	$43.2M
Medicare	$0

Key Findings

This facility is effectively a Medicaid-focused hospital: there is no Medicare billing on file for PROVIDENCE HEALTH & SERVICES - WASHINGTON, and all reported lifetime revenue is Medicaid-based totaling $43.2M. The absence of Medicare payments makes the provider’s financial footprint concentrated in state Medicaid relationships and programs rather than in a dual-payer mix.

Revenue concentration is significant: the precomputed top three Medicaid codes — 96361, 99283, and 99284 — together account for 43.3% of this provider’s total Medicaid revenue. Individually these top drivers include 96361 ($8.8M, 22.7%), 99283 ($4.7M, 12.2%), and 99284 ($3.2M, 8.4%), indicating a small number of high-impact services dominate revenue.

The code mix points to a high-volume emergency and infusion-centered operation. Multiple ED E/M codes appear among top revenue drivers (99283, 99284, 99285, 99282) alongside frequent IV administration codes (96361, 96365, 96360), which together suggest the hospital manages large emergency-department throughput and substantial parenteral therapy/infusion activity.

96361 is a standout clinical/revenue specialty for this provider: it generated $8.8M from 29.7K claims and ranks #8 of 105 providers in-state (93th percentile), described in the data as notably above typical state volume. That percentile and ranking indicate the hospital is a major regional provider of prolonged IV fluid/electrolyte administration relative to peers.

The hospital is a strong statewide competitor on several emergency visit codes but not uniquely dominant: 99283 ranks #22 of 234 providers (91th percentile) and 99284 ranks #29 of 225 providers (88th percentile), while the highest-acuity ED code 99285 ranks #37 of 192 (81th percentile). These ranks show above-typical ED volumes across acuity levels, consistent with a busy emergency department that is competitive within Washington but not necessarily the single market leader.

The provider also has concentrated procedural and imaging strength in gastroenterology and advanced diagnostics: 45385 (endoscopic polypectomy) produced $960.3K and ranks #4 of 90 providers (97th percentile), and 43239 (EGD with biopsy) produced $1.2M and ranks #9 of 119 providers (93th percentile). Those high percentiles indicate relatively elevated GI procedural volumes versus in-state peers and a meaningful procedural service-line presence.

Behavioral-health outpatient capacity is visible but narrower: S9480 (intensive outpatient psychiatric services) accounts for $3M (7.8% of Medicaid revenue) and ranks #4 of 15 providers in-state (79th percentile). The code’s presence and ranking suggest the hospital operates a notable IOP psychiatric program, although the statewide provider set for this code is small.

The provider has an established operational history—NPI enumerated on 2008-10-01 (~18 years ago)—and supports high patient throughput as reflected in claim volumes shown for routine and high-volume services (for example, 65.1K claims for 80053 and 48.5K claims for 99283). Combined with the $43.2M in Medicaid revenue and the concentration in a few high-revenue codes, these indicators point to a mature hospital with entrenched Medicaid service lines and sizable outpatient/ED volume.

Medicaid: Complete Services Breakdown

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

320 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	29,670	$300	$8.8M
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.	48,490	$100	$4.7M
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.	47,400	$70	$3.2M
S9480	Intensive outpatient psychiatric services, per diem	5,520	$540	$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.	31,120	$70	$2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	26,010	$80	$2M
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.	10,690	$170	$1.8M
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.	14,890	$110	$1.6M
J2323	Injection, natalizumab, 1 mg	1,110	$1,230	$1.4M
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.	4,450	$280	$1.2M

Showing 1–10 of 320

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 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

320 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J2350	Injection, ocrelizumab, 1 mg	4	10	330	$11,290	$4M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	29	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.	8	110	5,950	$270	$2.6M
S9480	Intensive outpatient psychiatric services, per diem	4	20	3,390	$220	$2M
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.	29	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.	22	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.	37	190	5,130	$100	$1.8M
J2323	Injection, natalizumab, 1 mg	3	10	1,110	$1,460	$1.5M
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.	23	140	2,830	$150	$1.1M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	22	100	1,940	$70	$1M

Showing 1–10 of 320

Related Providers

Other providers that share a Tax Identification Number (TIN) with Providence Health & Services - Washington, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mancong Zhang	WA	Anatomic Pathology & Clinical Pathology Physician	$150.2K	$0
Truc Pham	WA	Anatomic Pathology & Clinical Pathology Physician	$106.2K	$0
Georgi Pirumyan	WA	Anatomic Pathology & Clinical Pathology Physician	$97.1K	$0
Liqun Yin	WA	Anatomic Pathology & Clinical Pathology Physician	$89.4K	$0
Vibhav Bansal	IN	Vascular Neurology Physician	$86.8K	$0
Sydney Piercey	UT	Neurology Physician	$81.9K	$0
Carolina Valdes	FL	Neurology Physician	$66.4K	$0
Nathan Tagg	NC	Neurology Physician	$54.4K	$0
Christopher Montague	MN	Anatomic Pathology & Clinical Pathology Physician	$50.7K	$0
Jenny Hoffmann	WA	Anatomic Pathology & Clinical Pathology Physician	$48.9K	$0

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
American Behavioral Health Systems, Inc.	WA	Substance Abuse Rehabilitation Facility	$0	$60.5M
Community Health Association Of Spokane	WA	Federally Qualified Health Center (FQHC)	$0	$22.5M
Excelsior Wellness	WA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$11.8M
Center For Pediatric Therapy	WA	Physical Therapy Clinic/Center	$0	$9M
Emergency Physician Services Ps Holy Emergency Center	WA	Emergency Medicine Physician	$0	$8.2M
Patrick Bradley, Dds, PLLC	WA	Dental Clinic/Center	$0	$5.7M
Community Health Association Of Spokane	WA	Federally Qualified Health Center (FQHC)	$0	$5.5M
Ortc, LLC	WA	Methadone Clinic	$0	$3.4M
Arvind Chaudhry	WA	Hematology & Oncology Physician	$2.9M	$0
Mirela Andrei	WA	Medical Oncology Physician	$1M	$0

Providence Health & Services - Washington — 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