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.

Franciscan Medical Group (NPI 1366539421)

Key Findings

Field	Value
Entity Type	Organization
Organization	Franciscan Medical Group
Address	1717 S J St # Ms 20-15
City	Tacoma
State	WA
ZIP	98405
Taxonomy	Family Medicine Physician
NPI Enumerated	October 9, 2006

Payer Source	Total Paid
Medicaid	$92.6M
Medicare	$0

This provider is effectively a single‑payer Medicaid operator: there is no Medicare billing on file and total Medicaid revenue is $92.6M, indicating the practice’s entire reported federal payer footprint is concentrated in Medicaid. The absence of Medicare activity means comparative Medicare metrics and national peer context are not applicable for this entity.

Revenue concentration is heavily weighted toward a small set of office E/M codes: the top three Medicaid codes (99214, 99213, 99204) account for 68.9% of total Medicaid revenue, with 99214 alone representing $39.8M (47.3%) and 99213 contributing $14.5M (17.2%). That level of concentration signals material dependence on routine outpatient evaluation and management visits for the organization’s financial performance.

The code mix points to a large ambulatory primary care footprint with integrated preventive and pediatric services: extremely high volumes of 99214 (710.9K claims) and 99213 (302.2K claims) alongside preventive medicine codes 99392, 99391, and 99393 indicate ongoing, longitudinal primary care panels and robust well‑visit activity across age groups. These high-volume E/M and preventive codes are consistent with the provider taxonomy of Family Medicine Physician and suggest a practice organized around high visit throughput and continuity care.

Operational breadth extends beyond office visits into hospital and acute care: significant revenue from inpatient/subsequent care codes (99233 $3M, 99232 $2.1M, 99223 $1.7M) and discharge management (99239 $436.1K) indicates the group also provides substantive hospital-based services rather than being purely clinic-based. Several of those inpatient codes rank notably above typical in-state volume (e.g., 99233 ranks #4 of 143, 98th percentile; 99223 ranks #2 of 123, 99th percentile), underscoring a meaningful inpatient role.

The provider is a dominant in-state player for core outpatient E/M and several diagnostic imaging services: 99214 ranks #1 of 1823 providers in-state (100th percentile; extreme outlier) and 99213 ranks #2 of 1863 (100th percentile; extreme outlier), while 93306 (echocardiography) ranks #1 of 130 providers (100th percentile; extreme outlier). These rankings indicate market-leading volume in primary care visits and selected diagnostic modalities relative to state peers.

There is a pronounced maternal/OB imaging component to the practice: 76816 ($2.1M, 2.5%) ranks #1 of 96 providers in-state (100th percentile; extreme outlier), and additional pregnancy ultrasound codes 76811, 76805, and 76819 all appear in the top‑25 list with high ranks. The presence of multiple high‑rank obstetric ultrasound codes signals integrated prenatal imaging capacity and significant obstetric patient volume.

The practice offers diverse procedural and ancillary services beyond typical family medicine panels, including imaging and interventional work: 93306 echo ($1.4M), 43239 endoscopic biopsy ($615.7K), J0585 onabotulinumtoxina injections ($1.4M, 71th percentile; typical, unremarkable volume), and vaccine administration 90686 ($528.6K, rank #2). This breadth suggests the organization captures procedure and ancillary revenue streams in addition to E/M visits, expanding its service lines.

The entity shows long tenure and sustained scale: NPI enumerated 2006-10-09 (~20 years ago) and the dataset contains very large claim volumes for single codes (e.g., 710.9K claims for 99214 and 302.2K claims for 99213), consistent with a long‑standing, high‑throughput operation. High concentration in a few codes means reimbursement or policy changes affecting those primary E/M services could have outsized revenue impact on the organization.

Medicaid: Complete Services Breakdown

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

317 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…	710,930	$60	$39.8M
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…	302,210	$50	$14.5M
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…	46,820	$80	$3.7M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	61,850	$50	$3M
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	30,170	$70	$2.1M
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…	65,030	$30	$2.1M
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…	20,260	$100	$2M
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…	21,540	$90	$2M
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…	30,360	$60	$1.9M
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	18,950	$90	$1.7M

Showing 1–10 of 317

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

Franciscan Medical Group — 23 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

317 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G9149	National committee for quality assurance - level 2 medical home	82	90	1,680	$200	$1.5M
J0585	Injection, onabotulinumtoxina, 1 unit	11	40	1,040	$390	$518.8K
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…	1	1,820	480	$60	$379.6K
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…	1	130	890	$100	$337.8K
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	120	590	$230	$331.2K
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…	2	1,860	610	$40	$295.5K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	39	60	240	$380	$276.1K
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…	8	170	580	$30	$270.4K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	4	140	490	$40	$268.5K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	29	120	640	$100	$259.3K

Showing 1–10 of 317

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Of Washington	WA	General Acute Care Hospital	$0	$129.5M
Harborview Medical Center	WA	General Acute Care Hospital	$0	$128.2M
Fred Hutchinson Cancer Center	WA	General Acute Care Hospital	$0	$72.6M
The Association Of University Physicians	WA	Anesthesiology Physician	$0	$66.3M
Franciscan Health System	WA	General Acute Care Hospital	$0	$44.6M
Valley Medical Group-renton	WA	General Acute Care Hospital	$0	$28.3M
The Vancouver Clinic Inc Ps	WA	Internal Medicine Physician	$0	$28.2M
Multicare Health System	WA	Family Medicine Physician	$0	$25.8M
Franciscan Medical Group	WA	Internal Medicine Physician	$0	$7.7M
Franciscan Health System	WA	Internal Medicine Physician	$0	$6.4M

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	Family Medicine Physician	$0	$75M
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
Tacoma Emergency Care Physicians, PLLC	WA	Emergency Medicine Physician	$0	$12.1M
Multicare Health System	WA	Home Infusion Therapy Pharmacy	$0	$11.2M

Franciscan Medical Group — 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