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.

Ashley House (NPI 1568682797)

Field	Value
Entity Type	Organization
Organization	Ashley House
Address	33811 9th Ave S
City	Federal Way
State	WA
ZIP	98003
Taxonomy	Nursing Care Agency
NPI Enumerated	April 30, 2007

Payer Source	Total Paid
Medicaid	$46.5M
Medicare	$0

Key Findings

ASHLEY HOUSE is effectively a Medicaid-focused nursing care agency: Medicare revenue is none (no Medicare billing on file) while total Medicaid revenue is $46.5M, indicating virtually all reported payer activity is through Medicaid rather than Medicare. This single-payer profile should orient any competitive or utilization analysis toward state Medicaid policy and contracting dynamics.

Revenue is highly concentrated in a very small set of service codes: the top 3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue, with T1030 alone representing 97.0% of Medicaid revenue ($45.1M). That concentration means the provider’s financial scale is overwhelmingly driven by one high-revenue service line rather than a diversified mix of procedures.

The code mix identifies ASHLEY HOUSE as an in-home nursing operator focused on per-diem skilled nursing services: T1030 (Nursing care, in the home, by registered nurse, per diem) is the dominant code, supported by smaller volumes of private duty nursing (T1000) and licensed practical nurse per-diem care (T1031). The predominance of per-diem RN billing (T1030) implies ongoing, continuity-oriented in-home care rather than episodic clinic or outpatient visits.

Competitive standing is uneven across services: for T1030 the provider ranks #1 of 20 in-state and sits at the 100th percentile as an extreme outlier, meaning ASHLEY HOUSE is a statewide dominant filer for RN in-home per-diem services. By contrast, for T1000 the provider ranks #12 of 14 and is at the 15th percentile with typical, unremarkable volume, and for T1031 it is #1 of 1 with no state peer volume comparison available, indicating limited peer competition for that specific LPN per-diem filing pattern.

Operational scale and utilization metrics reinforce the RN per-diem concentration: T1030 shows 17.6K claims with a $2566 avg paid/claim and $45.1M revenue; T1000 shows 3.3K claims with a $368 avg paid/claim and $1.2M revenue; and T1031 shows 4.7K claims with a $33 avg paid/claim and $156.6K revenue. The combination of high claim count and very high average paid/claim for T1030 explains why it dominates total Medicaid revenue despite the provider offering several related nursing services.

This payer and code concentration has clear business implications: reliance on T1030 for 97.0% of Medicaid revenue creates substantial exposure to changes in Medicaid coverage, per-diem rates, or audit focus for that specific RN in-home service. At the same time, the provider’s extreme outlier status for T1030 suggests it has either developed specialized capacity or achieved a scale advantage in delivering RN in-home per-diem services that would be difficult for typical peers to match.

ASHLEY HOUSE’s NPI tenure (NPI enumerated: 2007-04-30 (~19 years ago)) indicates a long-established presence in the market; combined with $46.5M in Medicaid revenue and its extreme outlier ranking on T1030, this tenure supports the view of an established, specialized provider of in-home RN per-diem nursing services in Washington state.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1030	Nursing care, in the home, by registered nurse, per diem	17,580	$2,570	$45.1M
T1000	Private duty / independent nursing service(s) - licensed, up to 15 minutes	3,340	$370	$1.2M
T1031	Nursing care, in the home, by licensed practical nurse, per diem	4,750	$30	$156.6K

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

Ashley House — 1 of 3 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

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1000	Private duty / independent nursing service(s) - licensed, up to 15 minutes	12	10	14,140	$490	$12.6M
T1030	Nursing care, in the home, by registered nurse, per diem	1	20	530	$1,620	$2.8M
T1031	Nursing care, in the home, by licensed practical nurse, per diem	1	10	4,750	$30	$154.7K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Francis Community Hospital	WA	General Acute Care Hospital	$0	$44.7M
Wei Guo, Dmd,md,pllc	WA	Oral and Maxillofacial Surgery (Dentist)	$0	$8.3M
Multicare Health System	WA	Pediatrics Physician	$0	$6.9M
Sea Mar Community Health Centers	WA	Federally Qualified Health Center (FQHC)	$0	$6.8M
Healthpoint	WA	Federally Qualified Health Center (FQHC)	$0	$6.8M
Bridging Care, LLC	WA	Community/Behavioral Health Agency	$0	$6.5M
Ellen Polsky Dds And Bobby Virk Dmd, Ps	WA	Pediatric Dentistry	$0	$5.8M
Eid, Jaber, Jassar, PLLC	WA	Dental Clinic/Center	$0	$4.2M
Pediatric Specialty Practices, PLLC	WA	Pediatrics Physician	$0	$3.7M
Total Renal Care Inc	WA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3.5M

Ashley House — Billing Profile & Reimbursement Data

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Ashley House — 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

Nearby Providers

Frequently Asked Questions

References