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 1346250594)

Key Findings

Field	Value
Entity Type	Organization
Organization	Providence Health & Services Washington
Address	413 Lilly Rd Ne
City	Olympia
State	WA
ZIP	98506
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 9, 2006

Payer Source	Total Paid
Medicaid	$39.9M
Medicare	$0

This provider has no Medicare billing on file and reports $39.9M in lifetime Medicaid revenue, making its public payer footprint effectively Medicaid‑only in the available data. The absence of Medicare claims means payer‑mix analysis should treat this profile as single‑payer (Medicaid) rather than a mixed Medicare/Medicaid operation.

Revenue is highly concentrated: the precomputed top three Medicaid codes (99283, 96361, 99284) together account for 38.4% of this provider’s total Medicaid revenue. Individually those codes are listed as driving $4.1M (99283, 13.4%), $4M (96361, 12.9%), and $3.7M (99284, 12.1%) of the $39.9M total, indicating a relatively small set of services produce a large share of Medicaid receipts.

The code mix points to an emergency‑department and acute care orientation: the top revenue drivers are ED E/M codes 99283, 99284 and 99285 ($3.4M, 11.2% for 99285 also) alongside high volumes of IV infusion/rehydration codes such as 96361 and 96365. High claim counts (e.g., 99283: 38.8K claims; 99284: 39.1K claims; 96361: 13.5K claims) and substantial payments per claim for infusions (96361 avg $294) suggest the hospital operates a busy ED with frequent infusion/observation treatment activity rather than an outpatient clinic‑only profile.

Statewide competitive standing for the top ED and infusion codes is solid but not dominant: 99283 ranks #36 of 234 providers in‑state (85th percentile; described in the data as "typical, unremarkable volume for this code"), 99284 ranks #38 of 225 (83th percentile; "typical, unremarkable volume for this code"), and 96361 ranks #32 of 105 (70th percentile; "typical, unremarkable volume for this code"). In plain terms, the hospital shows above‑median activity on these core acute care codes relative to in‑state peers but the provided labels characterize those volumes as within typical ranges rather than extreme outliers.

Beyond ED services, imaging and procedural lines contribute meaningfully to Medicaid revenue: CT abdomen/pelvis with contrast 74177 accounts for $1.6M (5.1%) and CT head 70450 for $1.2M (3.8%), while echocardiography 93306 contributes $847.8K (2.8%). These imaging totals, together with CTA 71275 ($597.8K, 1.9%) and outpatient clinic visits G0463 ($739.8K, 2.4%), indicate a full‑service acute hospital with on‑site diagnostic imaging and cardiopulmonary testing supporting ED and inpatient workflows. All of these codes are reported with percentile ranks in the typical range for in‑state peers.

The provider shows notable volume in maternal and rehabilitative services: fetal nonstress testing 59025 accounts for $1.1M (3.6%) and ranks #13 of 116 (90th percentile; labeled "typical, unremarkable volume for this code"), while therapy codes 97530 ($878.9K, 2.9%) and 97112 ($432.8K, 1.4%) appear in the top 25 and are ranked at the 95th percentile for the state (both labeled "typical, unremarkable volume for this code"). These items suggest sustained OB and rehabilitation throughput alongside the ED and imaging load rather than isolated procedural activity.

There is evidence of pediatric and minor surgical capacity: tympanostomy with tube insertion 69436 generates $913.3K (3.0%) and ranks #6 of 32 (84th percentile; "typical, unremarkable volume for this code"), and tonsil/adenoid removal 42820 contributes $492.6K (1.6%). The presence of these higher‑paid, inpatient surgical codes in the top 25 supports an operational footprint that includes pediatric ENT and inpatient OR capacity.

The NPI enumeration date is 2006‑08‑09 (~20 years ago), indicating this provider has an established presence in the market. Combined with the Medicaid concentration and the code mix described above, the data are consistent with a long‑standing acute hospital that serves a substantial Medicaid population in Olympia and maintains broad acute, imaging, infusion, obstetric, rehab, and select pediatric surgical services.

Medicaid: Complete Services Breakdown

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

419 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	38,810	$110	$4.1M
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.	13,490	$290	$4M
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.	39,090	$100	$3.7M
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.	38,660	$90	$3.4M
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.	9,080	$170	$1.6M
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.	9,660	$120	$1.2M
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	7,130	$160	$1.1M
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	620	$1,470	$913.3K
96165	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of the patients’ physical health…	4,760	$190	$903.6K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	23,130	$40	$878.9K

Showing 1–10 of 419

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

419 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	37	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.	32	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.	38	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.	36	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.	30	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.	33	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…	31	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.	21	170	2,120	$40	$779.1K
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.	31	100	3,660	$100	$635.7K
96366	The provider administers an intravenous infusion or infusions of a medication for an additional hour or subsequent hours after the first hour to prevent, treat, or diagnose a condition or disease.	29	70	2,010	$210	$620.1K

Showing 1–10 of 419

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Providence Health & Services Washington	WA	Pulmonary Disease Physician	$0	$78.6M
Providence Health & Services Washington	WA	Family Medicine Physician	$0	$20M
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	Rural Health Clinic/Center	$0	$6.3M
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
Jocelyn De Yao	CO	Internal Medicine Physician	$607.2K	$0
Daniel Stroupe	IL	Infectious Disease Physician	$123.1K	$318K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Behavioral Health Resources	WA	Community/Behavioral Health Agency	$0	$40.7M
Harbor Health Solutions LLC	WA	Home Health Agency	$0	$8.6M
Olympia Emergency Services, PLLC	WA	Emergency Medicine Physician	$0	$6.5M
South Sound Pediatrics PLLC	WA	Pediatrics Physician	$0	$6.3M
Healthy Future Pediatrics	WA	Pediatrics Physician	$0	$4.3M
Neighborcare Health	WA	Federally Qualified Health Center (FQHC)	$0	$3.9M
Sea Mar Community Health Centers	WA	Federally Qualified Health Center (FQHC)	$0	$3.4M
Olympia Pediatrics, PLLC	WA	Specialist	$0	$2.7M
Gastroenterology Associates, LLC	WA	Ambulatory Surgical Clinic/Center	$1.2M	$1.2M
Aaron Utterback	WA	Podiatrist	$587.6K	$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