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.

Pediatrics Northwest Ps (NPI 1497841571)

Pediatrics Northwest Ps is a pediatrics physician provider located in Tacoma, Washington. This profile covers 0 Medicare and 51 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	Pediatrics Northwest Ps
Address	316 Martin Luther King Jr Way
City	Tacoma
State	WA
ZIP	98405
Taxonomy	Pediatrics Physician
NPI Enumerated	October 5, 2006

Payer Source	Total Paid
Medicaid	$6.5M
Medicare	$0

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

51 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…	20,210	$90	$1.8M
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…	24,520	$60	$1.4M
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…	9,640	$90	$819.5K
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…	8,170	$90	$743.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	4,710	$90	$428.2K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	2,650	$80	$222.6K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	910	$160	$148.2K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	1,290	$110	$139.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	890	$100	$87.2K
90688	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It uses split virus technology and is given as a 0.5 mL dose.	5,820	$10	$75.6K

Showing 1–10 of 51

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

Pediatrics Northwest Ps — 4 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

51 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.	8	10	410	$610	$385.4K
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…	97	1,820	480	$60	$379.6K
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…	116	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,…	51	60	240	$380	$276.1K
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…	18	280	540	$70	$166.5K
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…	25	300	400	$80	$164.4K
D0120	Periodic oral evaluation - established patient	418	920	690	$20	$131.3K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	393	540	130	$90	$128.6K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	10	50	130	$110	$119.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	33	320	290	$70	$104.8K

Showing 1–10 of 51

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	General Acute Care Hospital	$0	$77.8M
Multicare Health System	WA	Family Medicine Physician	$0	$75M
Multicare Health System	WA	General Acute Care Hospital	$0	$55.1M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Multicare Health System	WA	Community/Behavioral Health Agency	$0	$48.2M
Multicare Health System	WA	Internal Medicine Physician	$0	$46.6M
Multicare Health System	WA	General Acute Care Hospital	$0	$30.9M
Multicare Health System	WA	Pediatrics Physician	$0	$29.4M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Franciscan Medical Group	WA	Family Medicine Physician	$0	$92.6M
Franciscan Health System	WA	General Acute Care Hospital	$0	$44.6M
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
Multicare Health System	WA	Pediatrics Physician	$0	$11.1M
Smiles 4 Kids Allenmore, P.C.	WA	General Practice Dentistry	$0	$10.6M

Pediatrics Northwest Ps — Billing Profile & Reimbursement Data

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Pediatrics Northwest Ps — 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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