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.

Washington Gastroenterology PLLC (NPI 1306364401)

Washington Gastroenterology PLLC is a gastroenterology physician provider located in Tacoma, Washington. This profile covers 0 Medicare and 30 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	Washington Gastroenterology PLLC
Address	2202 S Cedar St Ste 330
City	Tacoma
State	WA
ZIP	98405
Taxonomy	Gastroenterology Physician
NPI Enumerated	September 8, 2017

Payer Source	Total Paid
Medicaid	$5.1M
Medicare	$0

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

30 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	18,170	$100	$1.8M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	400	$2,630	$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…	7,600	$60	$425.8K
J3380	Injection, vedolizumab, intravenous, 1 mg	70	$6,130	$398.6K
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…	7,130	$40	$299.5K
99204	The provider sees a new 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 provider…	2,150	$90	$200K
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.	2,730	$60	$171.8K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	1,560	$80	$124.9K
00731	The anesthesia provider performs anesthesia services for an unspecified type of upper gastrointestinal endoscopic procedure during which another provider introduces the endoscope to but not beyond…	920	$120	$107.6K
88342	The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,…	1,460	$60	$91.8K

Showing 1–10 of 30

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

Washington Gastroenterology PLLC — 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

30 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J1745	Injection, infliximab, excludes biosimilar, 10 mg	8	20	190	$1,670	$956.2K
J3380	Injection, vedolizumab, intravenous, 1 mg	3	10	70	$2,640	$684.6K
Q5103	Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg	7	10	340	$1,070	$498.5K
96415	In this add on procedure, the provider continues administration of a chemotherapy drug into a vein using an infusion technique. He uses this code to report each additional hour of infusion beyond the…	26	30	1,480	$220	$474.4K
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…	242	1,820	480	$60	$379.6K
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.	23	120	590	$230	$331.2K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	34	60	2,360	$70	$330.6K
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…	305	1,860	610	$40	$295.5K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	81	170	580	$30	$270.4K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	39	100	390	$260	$244.5K

Showing 1–10 of 30

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Michelle Hendrickx	WA	Family Nurse Practitioner	$481.1K	$0
Nasla Loya	WA	Family Nurse Practitioner	$435.5K	$0
Sharon Barker	WA	Physician Assistant	$434.5K	$0
Mark Lyda	WA	Anatomic Pathology & Clinical Pathology Physician	$400.7K	$0
John Scarborough	WA	Anatomic Pathology & Clinical Pathology Physician	$351.8K	$0
Angela Fields	WA	Anatomic Pathology & Clinical Pathology Physician	$343.1K	$0
Yuen Yee	WA	Gastroenterology Physician	$180.5K	$0
Narendra Siddaiah	WA	Gastroenterology Physician	$137.5K	$0
Stephanie Romine	WA	Family Nurse Practitioner	$128.1K	$0
Bryan Doherty	WA	Gastroenterology Physician	$109.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Multicare Health System	WA	General Acute Care Hospital	$0	$162.2M
Multicare Health System	WA	Children's Hospital	$0	$108.4M
Franciscan Medical Group	WA	Family Medicine Physician	$0	$92.6M
Multicare Health System	WA	Family Medicine Physician	$0	$75M
Franciscan Health System	WA	General Acute Care Hospital	$0	$44.6M
Multicare Health System	WA	Pediatrics Physician	$0	$29.4M
Western Psychological And Counseling Services LLC	WA	Clinical Psychologist	$0	$20.8M
Sound Health Medical Supply	WA	Customized Equipment (DME)	$0	$20.7M
Tra-minw P S	WA	Radiology Clinic/Center	$0	$14.5M
Advanced Lifeline Services	WA	SNF/Subacute Care Certified Respiratory Therapist	$0	$12.5M

Washington Gastroenterology PLLC — Billing Profile & Reimbursement Data

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Washington Gastroenterology PLLC — 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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