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.

Molina Healthcare Of Washington, Inc (NPI 1659897163)

Molina Healthcare Of Washington, Inc is a family medicine physician provider located in Bothell, Washington. This profile covers 0 Medicare and 74 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	Molina Healthcare Of Washington, Inc
Address	21540 30th Dr Se Ste 400
City	Bothell
State	WA
ZIP	98021
Taxonomy	Family Medicine Physician
NPI Enumerated	August 16, 2017

Payer Source	Total Paid
Medicaid	$7.8M
Medicare	$0

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

74 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99345	The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends at least 75…	24,780	$280	$6.9M
99350	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves high medical decision making or the provider spends at least 60…	2,110	$160	$329.6K
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.	31,520	$10	$283.7K
99501	A home health provider, such as a registered nurse, visits a patient and her newborn at home to review plans of care and provide additional resources to the patient.	1,930	$50	$94.6K
99205	The provider sees a new 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 provider…	450	$200	$90.3K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	160	$400	$63.3K
99344	The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider spends at least…	170	$130	$21K
99383	The provider performs a well–patient visit for a child who is between the ages of 5 and 11 who meets the definition of new patient.	150	$130	$19.3K
36416	In this procedure, the provider pricks the patient’s finger, heel, or ear with a pointed instrument and collects specimen of droplets of blood by pressing the pricking site.	1,660	$10	$18.3K
83037	The analyst performs a test using a drop of blood obtained by fingerstick or venipuncture from the patient to rapidly measure the level of glycosylated hemoglobin, HgbA1c. The analyst uses a device…	1,560	$10	$14.1K

Showing 1–10 of 74

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

Molina Healthcare Of Washington, Inc — 4 of 14 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

74 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99345	The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends at least 75…	1	10	110	$270	$1.4M
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…	459	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…	289	1,860	610	$40	$295.5K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	319	930	680	$60	$259.2K
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…	483	540	130	$90	$128.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	221	320	290	$70	$104.8K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	157	180	950	$10	$104.6K
99501	A home health provider, such as a registered nurse, visits a patient and her newborn at home to review plans of care and provide additional resources to the patient.	1	10	1,930	$50	$95.4K
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…	504	560	140	$70	$88.9K
99204	The provider sees a new 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 provider…	264	530	80	$90	$87.4K

Showing 1–10 of 74

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Seattle Children's Hospital	WA	Home Infusion Agency	$0	$32.2M
Michael Berven	WA	Diagnostic Radiology Physician	$138K	$3.6K
Parul Sharma	WA	Rheumatology Physician	$118.2K	$0
Michelle Wendt	WA	Physical Therapist	$81.7K	$0
Victoria Wright	WA	Speech-Language Pathologist	$29.3K	$0

Molina Healthcare Of Washington, Inc — 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