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.

Palomar Health (NPI 1376513754)

Field	Value
Entity Type	Organization
Organization	Palomar Health
Address	15615 Pomerado Road
City	Poway
State	CA
ZIP	92064
Taxonomy	General Acute Care Hospital
NPI Enumerated	January 26, 2006

Payer Source	Total Paid
Medicaid	$46.7M
Medicare	$0

Medicaid: Complete Services Breakdown

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

180 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
0450	N/A	24,160	$350	$8.5M
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.	24,800	$280	$6.9M
J3490	Unclassified drugs	34,160	$140	$4.9M
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	24,630	$130	$3.2M
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	11,670	$180	$2.1M
J1885	Injection, ketorolac tromethamine, per 15 mg	6,230	$310	$1.9M
97139	Use 97139 to report therapeutic procedures that do not have a specific code.	22,040	$50	$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.	3,660	$230	$841.8K
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.	4,920	$160	$806.2K
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.	5,330	$150	$777.6K

Showing 1–10 of 180

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

Palomar Health — 0 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

180 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
0450	N/A	200	450	16,140	$90	$3.6M
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.	199	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.	353	1,300	510	$100	$943K
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…	353	750	950	$50	$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.	379	1,400	470	$80	$884.5K
99281	The provider sees a patient for the lowest level emergency department visit.	307	430	1,140	$90	$769.9K
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.	249	780	1,160	$130	$576.2K
0762	N/A	135	160	770	$250	$419.8K
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.	185	660	1,490	$30	$417.2K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	305	510	3,760	$50	$383.4K

Showing 1–10 of 180

Related Providers

Other providers that share a Tax Identification Number (TIN) with Palomar Health, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Palomar Health	CA	General Acute Care Hospital	$0	$144.1M
Palomar Health	CA	Psychiatric Hospital Unit	$0	$42.2M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Michael Ammar	CA	Retina Specialist (Ophthalmology) Physician	$1.8M	$0
Shafi Khalid	CA	Interventional Pain Medicine Physician	$444.6K	$290.3K
Mark Vierra	CA	Specialist	$425.7K	$0
Kevin Owsley	CA	Sports Medicine (Orthopaedic Surgery) Physician	$296.2K	$0
Smitha Reddy	CA	Rheumatology Physician	$196.4K	$0
Michael Cutler	CA	Adult Medicine Physician	$159.6K	$0
Ashish Wadhwa	CA	Otolaryngology Physician	$158.9K	$0
Philip Balikian	CA	Orthopaedic Surgery Physician	$138.5K	$0
Michael Lin	CA	Diagnostic Radiology Physician	$118.9K	$0
Akber Safi	CA	Internal Medicine Physician	$96.3K	$0

Palomar Health — Billing Profile & Reimbursement Data

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Palomar Health — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References