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 California for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to California 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. California (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.

Pih Health Downey Hospital (NPI 1265433551)

Field	Value
Entity Type	Organization
Organization	Pih Health Downey Hospital
Address	11500 Brookshire Ave
City	Downey
State	CA
ZIP	90241
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 9, 2005

Payer Source	Total Paid
Medicaid	$25.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

256 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
0450	N/A	128,090	$40	$5.1M
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.	9,730	$170	$1.7M
0270	N/A	42,320	$20	$888.7K
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.	9,910	$90	$862.2K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	19,750	$40	$849.2K
99281	The provider sees a patient for the lowest level emergency department visit.	9,760	$80	$781.1K
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.	6,570	$110	$716.1K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	38,030	$20	$684.6K
0250	N/A	33,990	$20	$543.8K
93975	The provider performs a complete study of the abdominal, pelvic, scrotal, and or retroperitoneal organs using duplex ultrasound. He performs the procedure to examine the vascular supply to the organs…	3,480	$140	$500.5K

Showing 1–10 of 256

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other California providers billing the same CPT/HCPCS codes.

Claims Volume vs. California Distribution

Pih Health Downey Hospital — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. California median

256 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
0450	N/A	35	450	16,140	$90	$3.6M
0121	N/A	54	70	130	$4,600	$2.6M
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	360	390	1,270	$220	$1.5M
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.	467	1,570	680	$110	$1.1M
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.	630	1,300	510	$100	$943K
0214	N/A	13	30	160	$2,730	$890K
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.	351	1,400	470	$80	$884.5K
99281	The provider sees a patient for the lowest level emergency department visit.	90	430	1,140	$90	$769.9K
U0004	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…	87	150	580	$60	$608.7K
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.	96	780	1,160	$130	$576.2K

Showing 1–10 of 256

Nearby Providers

Other providers in the same ZIP code as Pih Health Downey Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ajay Patel	CA	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$393.8K	$1.1M
Munther Hijazin	CA	Neurology Physician	$405.2K	$70
Gerard Nat	CA	Dermatology Physician	$365.1K	$0
Brian Brown	CA	Ophthalmology Physician	$201.6K	$1.4K
Joseph Hsu	CA	Ophthalmology Physician	$141.1K	$0
Michael Nguyen	CA	Anesthesiology Physician	$91.2K	$13.1K
Mark Dubin	CA	Diagnostic Radiology Physician	$102.3K	$580
Mohammad Raffat Jaber	CA	Vascular Surgery Physician	$65.2K	$3.5K
Lindsay Zamis Dellamaggiora	CA	Anatomic Pathology & Clinical Pathology Physician	$28.1K	$0

Pih Health Downey Hospital — Billing Profile & Reimbursement Data

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Pih Health Downey Hospital — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References