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 1457321317)

Field	Value
Entity Type	Organization
Organization	Palomar Health
Address	2185 Citracado Pkwy
City	Escondido
State	CA
ZIP	92029
Taxonomy	General Acute Care Hospital
NPI Enumerated	January 24, 2006

Payer Source	Total Paid
Medicaid	$144.1M
Medicare	$0

Key Findings

Palomar Health shows no Medicare billing on file and is effectively a single-payer provider in this dataset, with Medicaid accounting for its reported lifetime revenue of $144.1M. This concentration means Medicaid policy and rate changes will materially affect the provider's revenue base in ways that Medicare adjustments would not.

Revenue concentration is high: the precomputed top three Medicaid codes (0450, 99283, J3490) together account for 50.7% of the provider's total Medicaid revenue. Individually those codes bring in $19.8M revenue (17.3%), $19.7M revenue (17.2%), and $18.7M revenue (16.3%) respectively, indicating a small set of services drive the majority of Medicaid receipts.

The code mix indicates a high-volume emergency and acute-care operation: 99283 ($19.7M, 17.2% of Medicaid revenue) and related higher-acuity ED codes 99284 and 99285 appear prominently, supporting that Palomar functions as an emergency-focused acute hospital. High volumes of basic and comprehensive metabolic panels (80048, 80053) and frequent imaging codes (70450, 74177, 74176) further support substantial inpatient/ED diagnostic throughput.

J3490 (Unclassified drugs) is an extreme outlier in the state: Palomar reported $18.7M revenue for J3490 (16.3% of Medicaid revenue) and ranks #11 of 1388 providers in-state (99th percentile; extreme outlier). This suggests unusually large Medicaid billing for unclassified drug items or miscellaneous injectable/infusible agents that are captured under that code.

Competitive standing for emergency services is strong within California: 99283 ranks #52 of 1570 providers in-state (97th percentile; notably above typical state volume), and several lab and imaging codes (80048 rank #27 of 1122, 80053 rank #211 of 1717) are at or above the 88th–98th percentiles, indicating Palomar is a major Medicaid-volume participant for ED diagnostics and testing. Conversely, 0450 ($19.8M, 17.3%) ranks #124 of 450 (73th percentile; typical), showing not all top revenue codes are outlier volumes.

Several ancillary service codes show elevated state-level volume: 0250 ($2.7M) ranks in the 98th percentile, 93005 ($1.4M) ranks in the 97th percentile, and 72125 ($1M) is in the 98th percentile. These high-percentile placements across diverse service lines reinforce that Palomar is a high-utilization center for both diagnostic testing and basic procedural services under Medicaid.

Operational tenure is long: the provider's NPI was enumerated on 2006-01-24 (~20 years ago), indicating two decades of active enrollment that supports continuous billing history and entrenched regional presence. This longevity combined with high state-percentile volumes suggests stable, established service lines rather than a recent ramp-up.

Given the concentration in a few high-revenue codes and multiple state-percentile outliers, payers and provider analysts should treat Palomar as a high-volume Medicaid acute-care hospital with specific revenue exposure to ED visits, unclassified drug billing (J3490), and a broad suite of diagnostic labs and imaging. Contracting, utilization management, and drug-billing policies targeted at these areas are likely to have outsized impact on overall Medicaid spend with this provider.

Medicaid: Complete Services Breakdown

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

324 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
0450	N/A	57,030	$350	$19.8M
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.	66,540	$300	$19.7M
J3490	Unclassified drugs	104,490	$180	$18.7M
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…	72,010	$130	$9.1M
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.	36,300	$250	$9M
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.	18,320	$270	$4.9M
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.	12,960	$300	$3.9M
Q9967	Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	11,690	$300	$3.5M
0250	N/A	47,760	$60	$2.7M
J7030	Infusion, normal saline solution , 1000 cc	14,170	$190	$2.6M

Showing 1–10 of 324

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 — 9 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

324 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
0120	N/A	37	40	110	$6,750	$3.9M
0450	N/A	124	450	16,140	$90	$3.6M
0121	N/A	23	70	130	$4,600	$2.6M
0206	N/A	10	40	80	$2,760	$1.1M
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.	52	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.	217	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…	175	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.	233	1,400	470	$80	$884.5K
99281	The provider sees a patient for the lowest level emergency department visit.	163	430	1,140	$90	$769.9K
G0378	Hospital observation service, per hour	65	200	550	$310	$605.9K

Showing 1–10 of 324

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	$46.7M
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
Pomerado Outpatient Surgical Center L P	CA	Ambulatory Surgical Clinic/Center	$991.5K	$0
Anatoly Bulkin	CA	Vascular Surgery Physician	$735.4K	$4.8K
Alexander Chang	CA	Surgery Physician	$300.2K	$670
Arush Patel	CA	Orthopaedic Hand Surgery Physician	$271.9K	$0
Julian Anthony	CA	Urology Physician	$202.4K	$0
Chunyang Wang	CA	Neurology Physician	$114.1K	$0
Brian Goelitz	CA	Vascular & Interventional Radiology Physician	$113.1K	$0
Lorra Sharp	CA	Orthopaedic Trauma Physician	$89.8K	$0
Pragya Gupta	CA	Interventional Pain Medicine Physician	$74.9K	$0
Danny Valentine	CA	Anesthesiology Physician	$45K	$0

Palomar Health — 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