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.

Multicare Health System (NPI 1326093873)

Key Findings

Field	Value
Entity Type	Organization
Organization	Multicare Health System
Address	315 Martin Luther King Jr Way
City	Tacoma
State	WA
ZIP	98405
Taxonomy	Family Medicine Physician
NPI Enumerated	May 23, 2006

Payer Source	Total Paid
Medicaid	$75M
Medicare	$0

MULTICARE HEALTH SYSTEM is effectively a single-payer Medicaid reporter at the Medicare/Medicaid level: there is no Medicare billing on file and total Medicaid revenue on record is $75M. This concentration of recorded activity means analyses should treat Medicaid as the primary revenue stream when modeling payer mix or access patterns for this entity.

Revenue is highly concentrated in a small set of outpatient evaluation-and-management and lab codes: the top 3 Medicaid codes by revenue account for 69.5% of this provider's total Medicaid revenue, led by 99214 ($23.5M revenue, 33.4%), 99213 ($19.3M revenue, 27.5%), and 87636 ($6M revenue, 8.6%). This concentration implies that changes to reimbursement or utilization patterns for these codes would materially affect overall Medicaid revenue.

The procedure and E/M code mix indicates large-scale ambulatory primary care and associated diagnostic services: extremely high volumes of office visit codes 99213 (426.4K claims) and 99214 (426.4K claims) point to a heavy outpatient/primary-care throughput, while substantial new-patient visits (99203, $5.8M) and diagnostic testing (87636, 47.1K claims) show integrated testing capacity co-located with clinical visits. Together these patterns are consistent with a multi-site clinical operation providing high-volume primary care and in-clinic lab testing.

Claims for hospital-based and acute care services are also prominent, showing that the provider's footprint extends into inpatient and emergency care: 99291 (33.8K claims, $3.2M revenue) and subsequent inpatient care codes like 99232 (46.5K claims, $1.6M revenue) appear in the top-paid Medicaid mix, and emergency visit codes 99283/99284/99285 are present as well. These items indicate substantial hospital/ED clinical activity in addition to outpatient visits, so payers should consider both ambulatory and acute-site utilization in contracting or network analyses.

Statewide competitive standing is dominant on multiple high-revenue codes: the provider ranks #1 of 1863 in-state for 99213 (100th percentile; extreme outlier) and #3 of 1823 for 99214 (100th percentile; extreme outlier), while 87636 ranks #1 of 44 providers in-state (100th percentile; extreme outlier). Numerous other codes (for example, 99203, 99291, 93306, 99243, and 93971) also sit at or near the top of state rankings, signaling that MULTICARE operates at scale and is a major Medicaid competitor across several service lines.

The mix includes substantial specialized diagnostics and procedures beyond office visits, reflecting service diversification: high-volume cardiac imaging 93306 ($1.6M revenue), ultrasound/OB imaging codes like 76811 and 76816, vascular duplex 93971 (rank #1, $190.6K revenue), and procedure codes such as J0585 (onabotulinumtoxina, $1.2M revenue) and 42820 (tonsil/adenoid removal, $408.5K revenue) appear in the top code list. This breadth suggests the organization bills for a wide range of specialty diagnostics and procedural services under its Medicaid activities.

Several top codes are labeled as statistical outliers within the state, which has implications for peer benchmarking and utilization reviews: codes such as 99213, 99214, 87636, 99203, 99291, 93306, 99215, 59025, 87651, 99243, and 93971 are described as "extreme outlier" or similarly characterized (100th–99th percentiles) in their state rankings. Analysts should treat these code-level volumes as exceptional relative to in-state peers and investigate whether site mix, centralized lab/diagnostic capacity, or multi-location billing practices explain the deviations.

The NPI was enumerated on 2006-05-23 (~20 years ago), indicating a long-tenured billing presence in the Medicaid program; this longevity supports the interpretation that the observed high volumes reflect established service lines and long-standing provider relationships with the state Medicaid program. Tenure combined with the concentrated revenue profile suggests stability of core services but also potential vulnerability to policy or reimbursement shifts affecting the few codes that drive most revenue.

Medicaid: Complete Services Breakdown

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

344 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	426,410	$60	$23.5M
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…	378,750	$50	$19.3M
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…	47,090	$130	$6M
99203	The provider sees a new 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 provider…	83,020	$70	$5.8M
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	33,830	$100	$3.2M
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…	46,540	$30	$1.6M
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	29,300	$50	$1.6M
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…	20,260	$60	$1.2M
J0585	Injection, onabotulinumtoxina, 1 unit	1,420	$850	$1.2M
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…	9,300	$80	$762.6K

Showing 1–10 of 344

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

Multicare Health System — 15 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

344 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	89	110	5,950	$270	$2.6M
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.	102	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.	77	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.	132	190	5,130	$100	$1.8M
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.	61	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…	88	100	1,940	$70	$1M
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	128	170	2,120	$40	$779.1K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	91	140	2,410	$110	$593.3K
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.	78	130	2,770	$90	$588.4K
J0585	Injection, onabotulinumtoxina, 1 unit	14	40	1,040	$390	$518.8K

Showing 1–10 of 344

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Franciscan Medical Group	WA	Family Medicine Physician	$0	$92.6M
Franciscan Health System	WA	General Acute Care Hospital	$0	$44.6M
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
Tacoma Emergency Care Physicians, PLLC	WA	Emergency Medicine Physician	$0	$12.1M
Multicare Health System	WA	Home Infusion Therapy Pharmacy	$0	$11.2M
Multicare Health System	WA	Pediatrics Physician	$0	$11.1M
Smiles 4 Kids Allenmore, P.C.	WA	General Practice Dentistry	$0	$10.6M

Multicare Health System — Billing Profile & Reimbursement Data

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Multicare Health System — 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

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
Multicare Health System	WA	General Acute Care Hospital	$0	$77.8M
Multicare Health System	WA	General Acute Care Hospital	$0	$55.1M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Multicare Health System	WA	Community/Behavioral Health Agency	$0	$48.2M
Multicare Health System	WA	Internal Medicine Physician	$0	$46.6M
Multicare Health System	WA	General Acute Care Hospital	$0	$30.9M
Multicare Health System	WA	Pediatrics Physician	$0	$29.4M
Multicare Health System	WA	Family Medicine Physician	$0	$25.8M