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 1255685822)

Field	Value
Entity Type	Organization
Organization	Providence Health & Services Washington
Address	1200 E Columbia Ave
City	Colville
State	WA
ZIP	99114
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	November 5, 2012

Payer Source	Total Paid
Medicaid	$6.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

43 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	50,430	$80	$4M
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…	27,280	$40	$1.1M
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…	14,090	$50	$662.3K
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…	3,070	$80	$248.5K
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…	1,160	$90	$98.7K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	3,750	$10	$41.2K
87631	The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,…	210	$120	$25K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	190	$80	$15.7K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	2,000	$10	$14K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	600	$10	$7.2K

Showing 1–10 of 43

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 — 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

43 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	64	650	4,110	$250	$4.9M
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…	138	1,820	480	$60	$379.6K
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…	106	1,860	610	$40	$295.5K
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…	907	930	680	$60	$259.2K
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…	56	280	540	$70	$166.5K
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…	101	300	400	$80	$164.4K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	306	390	420	$50	$152.3K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	466	540	130	$90	$128.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	180	320	290	$70	$104.8K
87631	The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,…	45	60	730	$60	$102.1K

Showing 1–10 of 43

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
Providence Health & Services Washington	WA	Pulmonary Disease Physician	$0	$78.6M
Providence Health & Services Washington	WA	General Acute Care Hospital	$0	$39.9M
Providence Health & Services Washington	WA	Clinical Medical Laboratory	$1.6M	$9.3M
Providence Health & Services- Washington	WA	General Practice Physician	$0	$7.6M
Providence Health & Services Washington	WA	Ambulatory Surgical Clinic/Center	$271.6K	$1.7M
Providence Health & Services Mt	MT	Psychiatric/Mental Health Nurse Practitioner	$0	$1.8M
Daniel Baird	WA	Dermatology Physician	$739.5K	$0
Rebecca Muntean	WA	Rheumatology Physician	$290.8K	$0
Sanjit Dutta	WA	Internal Medicine Physician	$216.7K	$0
Michael Kwasman	WA	Clinical Cardiac Electrophysiology Physician	$213.3K	$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
Providence Health & Services - Washington	WA	Critical Access Hospital	$0	$26.8M
New Health Program Association	WA	Federally Qualified Health Center (FQHC)	$0	$10.4M
Rural Resources Community Action	WA	Case Management Agency	$0	$10.1M
Stevens County	WA	Land Ambulance	$477.5K	$1.1M
Robert Sumner	WA	Physical Therapist	$230.3K	$0
William Magee	WA	Sports Medicine (Orthopaedic Surgery) Physician	$62.6K	$0
Launa Lister	WA	Nurse Practitioner	$55.2K	$0
William Hartman	WA	Physician Assistant	$43.7K	$0
Richard Cardenas	WA	Physician Assistant	$5K	$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

Related Providers

Nearby Providers

Frequently Asked Questions

References