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.

Tri-state Memorial Hospital (NPI 1598814352)

Tri-state Memorial Hospital is a critical access hospital provider located in Clarkston, Washington. This profile covers 0 Medicare and 59 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	Tri-state Memorial Hospital
Address	1221 Highland Ave
City	Clarkston
State	WA
ZIP	99403
Taxonomy	Critical Access Hospital
NPI Enumerated	January 10, 2007

Payer Source	Total Paid
Medicaid	$3.7M
Medicare	$0

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

59 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…	21,260	$60	$1.3M
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…	18,190	$50	$963.9K
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.	12,780	$40	$536.9K
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.	5,360	$70	$391.2K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	6,030	$30	$205.1K
99203	The provider sees a new 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 provider…	820	$70	$61K
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.	1,000	$50	$53.9K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	4,300	$10	$21.5K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	470	$40	$16.5K
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…	2,960	$10	$14.8K

Showing 1–10 of 59

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

Tri-state Memorial Hospital — 1 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

59 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	116	230	5,440	$90	$1.8M
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.	87	230	6,220	$100	$1.8M
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.	186	190	5,130	$100	$1.8M
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.	88	140	2,830	$150	$1.1M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	113	140	2,410	$110	$593.3K
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.	98	130	2,770	$90	$588.4K
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…	94	1,820	480	$60	$379.6K
82075	The lab analyst performs the technical lab test to analyze the quantitative amount of alcohol in a patient’s breath and correlates the measurement to blood alcohol content.	20	30	820	$20	$367.8K
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.	97	100	990	$170	$343.7K
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…	146	1,860	610	$40	$295.5K

Showing 1–10 of 59

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tri-state Memorial Hospital	WA	Critical Access Hospital	$0	$14.5M
Cory Brown	WA	Foot & Ankle Surgery Podiatrist	$1.5M	$0
Vannvei LLC	ID	Multi-Specialty Clinic/Center	$0	$581.6K
Shoaib Ahmad	OK	Pulmonary Disease Physician	$276.1K	$0
Mark Harwood	WA	Clinical Cardiac Electrophysiology Physician	$259.5K	$0
Thomas Klein	WA	Clinical Cardiac Electrophysiology Physician	$247.4K	$0
Gerhard Muelheims	WA	Clinical Cardiac Electrophysiology Physician	$230.9K	$0
Michael Kwasman	WA	Clinical Cardiac Electrophysiology Physician	$213.3K	$0
Carl Walker	WA	Urology Physician	$209.2K	$0
John Rudolph	ID	Family Medicine Physician	$193.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Health Association Of Spokane	WA	Federally Qualified Health Center (FQHC)	$0	$14.6M
City Of Clarkston	WA	Land Ambulance	$204.4K	$695.9K
Mark Eggleston	WA	Ophthalmology Physician	$396.4K	$0
Chad Bouterse	WA	Ophthalmology Physician	$345K	$0
Costco Wholesale Corporation	WA	Community/Retail Pharmacy	$323K	$0
Walter Williams	WA	Dermatology Physician	$268.7K	$0
Eye Care Specialists Ps	WA	Ambulatory Surgical Clinic/Center	$248K	$0
Bryan Beardsley	WA	Orthopaedic Surgery Physician	$157.1K	$0
Brooksie Larson	WA	Physical Therapist	$153.4K	$0
Carol Chandler	WA	Nurse Practitioner	$131.5K	$0

Tri-state Memorial Hospital — Billing Profile & Reimbursement Data

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Tri-state Memorial Hospital — 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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