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.

Swedish Health Services (NPI 1689612954)

Swedish Health Services is a internal medicine physician provider located in Seattle, Washington. This profile covers 0 Medicare and 197 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	Swedish Health Services
Address	800 5th Ave
City	Seattle
State	WA
ZIP	98104
Taxonomy	Internal Medicine Physician
NPI Enumerated	June 2, 2006

Payer Source	Total Paid
Medicaid	$21.1M
Medicare	$0

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

197 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…	86,910	$50	$4.1M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	90,750	$30	$3.1M
J0585	Injection, onabotulinumtoxina, 1 unit	3,410	$760	$2.6M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	31,760	$50	$1.5M
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…	38,920	$40	$1.5M
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…	14,110	$90	$1.3M
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…	13,410	$60	$844.9K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	14,120	$40	$593.2K
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…	9,870	$60	$582.6K
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.	9,010	$60	$576.6K

Showing 1–10 of 197

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

Swedish Health Services — 12 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

197 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.	217	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.	150	230	6,220	$100	$1.8M
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.	122	140	2,410	$110	$593.3K
J0585	Injection, onabotulinumtoxina, 1 unit	3	40	1,040	$390	$518.8K
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	1,820	480	$60	$379.6K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	38	120	590	$230	$331.2K
54161	The provider excises the foreskin of a patient older than 28 days; the provider uses a technique other than a clamp, other devices, or dorsal slit.	10	10	100	$1,000	$329.3K
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…	76	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,…	20	60	240	$380	$276.1K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	5	170	580	$30	$270.4K

Showing 1–10 of 197

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Swedish Health Services	WA	General Acute Care Hospital	$0	$125.3M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Swedish Health Services	WA	General Acute Care Hospital	$0	$20.1M
Swedish Health Services	WA	General Acute Care Hospital	$0	$13.3M
Swedish Health Services	WA	Family Medicine Physician	$0	$11.1M
Providence Health & Services- Washington	WA	General Practice Physician	$0	$7.6M
Eastside Emergency Physicians PLLC	WA	Emergency Medicine Physician	$0	$5M
Pacmed Clinics	WA	Multi-Specialty Clinic/Center	$0	$4.5M
Rafal Sosnowski	IL	Diagnostic Radiology Physician	$1.7M	$75.2K
Kristine Rinn	WA	Medical Oncology Physician	$855.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Harborview Medical Center	WA	General Acute Care Hospital	$0	$128.2M
Seattle-king County Dept Of Public Health	WA	Case Manager/Care Coordinator	$0	$74M
The Association Of University Physicians	WA	Anesthesiology Physician	$0	$66.3M
Seattle-king County Dept Of Public Health	WA	Dental Clinic/Center	$0	$62.9M
Bloodworks	WA	Community/Retail Pharmacy	$0	$56.8M
International Community Health Services	WA	Dentist	$0	$16M
Northwest Kidney Centers	WA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$7.2M
King County Finance	WA	State or Local Public Health Clinic/Center	$0	$5.7M
Downtown Emergency Service Center	WA	Community/Behavioral Health Agency	$0	$3.3M
The Young Mens Christian Association Of Greater Seattle	WA	Health Educator	$6K	$2.8M

Swedish Health Services — Billing Profile & Reimbursement Data

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Swedish Health Services — 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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