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.

Providence Health System - Southern California (NPI 1477587632)

Field	Value
Entity Type	Organization
Organization	Providence Health System - Southern California
Address	15031 Rinaldi St
City	Mission Hills
State	CA
ZIP	91345
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 11, 2006

Payer Source	Total Paid
Medicaid	$54.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

304 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
0450	N/A	218,380	$70	$15.1M
99281	The provider sees a patient for the lowest level emergency department visit.	28,360	$130	$3.6M
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.	78,090	$40	$3M
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.	16,850	$160	$2.7M
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	13,050	$170	$2.2M
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	22,560	$70	$1.6M
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.	5,490	$240	$1.3M
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	41,240	$30	$1M
Z7502	N/A	28,630	$40	$1M
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	51,160	$20	$972K

Showing 1–10 of 304

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

Providence Health System - Southern California — 7 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

304 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	248	250	2,420	$220	$3.7M
0450	N/A	8	450	16,140	$90	$3.6M
0121	N/A	56	70	130	$4,600	$2.6M
0206	N/A	22	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.	385	1,570	680	$110	$1.1M
A0425	Ground mileage, per statute mile	557	580	3,120	$30	$963.2K
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.	308	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…	127	750	950	$50	$890K
0214	N/A	14	30	160	$2,730	$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.	320	1,400	470	$80	$884.5K

Showing 1–10 of 304

Nearby Providers

Other providers in the same ZIP code as Providence Health System - Southern California, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Frank Lusher	CA	Dermatology Physician	$241.3K	$2.2M
Ramin Ganjianpour	CA	Specialist	$1.2M	$9.4K
Mark Gobrial	CA	Internal Medicine Physician	$736.2K	$0
Kiumars Arfai	CA	Pain Medicine (Anesthesiology) Physician	$710.6K	$3.9K
San Fernando Valley Surgery Center, LP	CA	Ambulatory Surgical Clinic/Center	$690.4K	$24K
Jonathan De Guzman	CA	Surgical Physician Assistant	$10K	$0

Providence Health System - Southern California — Billing Profile & Reimbursement Data

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Providence Health System - Southern California — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References