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 1497752091)

Providence Health & Services- Washington is a rehabilitation hospital provider located in Spokane, Washington. This profile covers 0 Medicare and 41 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Providence Health & Services- Washington
Address	711 S Cowley St
City	Spokane
State	WA
ZIP	99202
Taxonomy	Rehabilitation Hospital
NPI Enumerated	June 28, 2005

Payer Source	Total Paid
Medicaid	$8M
Medicare	$0

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

41 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	51,050	$40	$2.2M
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	67,130	$30	$1.7M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	30,140	$40	$1.3M
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	21,900	$30	$591.2K
97533	In this procedure, the provider uses sensory integrative techniques in patients with established dysfunction of sensory processing, for example, children with autism, and brain injuries. This service…	11,550	$40	$427.3K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	21,620	$20	$367.5K
97113	The provider instructs and supervises the patient on aquatic therapeutic exercises for one or more areas of the body for a period of 15 minutes.	8,470	$40	$364.3K
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	4,730	$50	$222.3K
97162	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	5,170	$40	$222.1K
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	7,200	$20	$136.8K

Showing 1–10 of 41

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 — 11 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

41 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	7	10	410	$610	$385.4K
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,…	38	60	240	$380	$276.1K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	12	280	1,920	$40	$262.1K
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.	6	590	1,280	$50	$244.5K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	3	480	1,160	$30	$180.9K
97533	In this procedure, the provider uses sensory integrative techniques in patients with established dysfunction of sensory processing, for example, children with autism, and brain injuries. This service…	1	20	540	$70	$129.6K
92508	The provider treats a group of two or more individuals with communication and hearing difficulties by directly interacting with them. He assesses the patients with impairment in their ability to make…	105	110	3,570	$10	$112.9K
95800	A patient undergoes a sleep study with no provider physically present. Parameters recorded include heart rate, blood oxygen concentration, respiratory analysis, and the amount of time sleeping.	13	20	290	$180	$103.1K
95811	During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.	40	40	140	$290	$100.9K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	14	340	1,240	$20	$96.8K

Showing 1–10 of 41

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dieter Lubbe	WA	Interventional Cardiology Physician	$117K	$0
Deirdre Mooney	WA	Advanced Heart Failure and Transplant Cardiology Physician	$99.5K	$0
Rachel Le	WA	Cardiovascular Disease Physician	$72.3K	$0
Branden Reynolds	WA	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$58.7K	$0
Jonathan Morrill	WA	Physical Medicine & Rehabilitation Physician	$38.5K	$0
Joy White Martinez	WA	Rehabilitation Psychologist	$34.7K	$0
Laurie Mcgee	WA	Nurse Practitioner	$33.6K	$0
Alicia Hegie	WA	Clinical Neuropsychologist	$26.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Multicare Health System	WA	Internal Medicine Physician	$0	$46.6M
Frontier Behavioral Health	WA	Community/Behavioral Health Agency	$0	$34.3M
Dungarvin Washington Children's Services, LLC	WA	Developmental Disabilities Clinic/Center	$0	$21.3M
Community Health Association Of Spokane	WA	Federally Qualified Health Center (FQHC)	$0	$8.2M
Compass Career Solutions LLC	WA	Developmentally Disabled Services Day Training Agency	$0	$7.7M
Inland Imaging LLC	WA	Diagnostic Radiology Physician	$0	$6.8M
Northwest Autism Center	WA	Community/Behavioral Health Agency	$0	$5.9M
Northwest Pediatric Ophthalmology	WA	Ophthalmology Physician	$0	$4.2M
Inland Northwest Renal Care Group, LLC	WA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.1M
Collin Perri	WA	Physician Assistant	$3.8M	$0

Providence Health & Services- Washington — Billing Profile & Reimbursement Data

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Providence Health & Services- Washington — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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