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.

Saint Clare Hospital (NPI 1689672693)

Saint Clare Hospital is a general acute care hospital provider located in Lakewood, Washington. This profile covers 0 Medicare and 294 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	Saint Clare Hospital
Address	11315 Bridgeport Way Sw
City	Lakewood
State	WA
ZIP	98499
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 13, 2005

Payer Source	Total Paid
Medicaid	$30M
Medicare	$0

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

294 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	18,250	$300	$5.4M
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.	37,430	$100	$3.8M
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.	38,760	$80	$3M
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.	24,480	$80	$2M
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.	9,230	$160	$1.5M
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.	13,860	$90	$1.3M
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.	9,280	$130	$1.2M
96366	The provider administers an intravenous infusion or infusions of a medication for an additional hour or subsequent hours after the first hour to prevent, treat, or diagnose a condition or disease.	4,450	$210	$944K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	9,520	$90	$866.1K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	13,360	$50	$694.7K

Showing 1–10 of 294

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

Saint Clare Hospital — 0 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

294 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	35	100	2,830	$80	$3.8M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	18	110	5,950	$270	$2.6M
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.	40	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.	37	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.	46	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.	31	140	2,830	$150	$1.1M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	59	100	1,940	$70	$1M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	15	20	190	$1,670	$956.2K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	22	170	2,120	$40	$779.1K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	25	100	3,660	$100	$635.7K

Showing 1–10 of 294

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Francis Community Hospital	WA	General Acute Care Hospital	$0	$44.7M
Nagavedu Raghunath	WA	Psychiatry Physician	$116.7K	$0
James Howard	WA	Psychiatry Physician	$75.6K	$0
Fletcher Taylor	WA	Psychiatry Physician	$50.6K	$0
Joy Jones	WA	Psychiatry Physician	$19.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Greater Lakes Mental Health Foundation Inc	WA	Mental Illness Community Based Residential Treatment Facility	$0	$56M
Rainier Internal Medicine LLC	WA	Primary Care Clinic/Center	$164.9K	$35.1M
Pediatric Services Of America, LLC	WA	Nursing Care Agency	$0	$22.4M
Capstone Medical LLC	WA	Durable Medical Equipment & Medical Supplies	$0	$20.7M
Chen And Su, Ps	WA	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$6.3M
Wchs Inc	WA	Methadone Clinic	$171.3K	$6M
Total Renal Care Inc	WA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.6M
Thi Nguyen	WA	General Practice Dentistry	$0	$3.7M
Asian American Chemical Dependency Treatment Services	WA	Community/Behavioral Health Agency	$0	$3.5M
Neurostim Tms, Ps	WA	Psychiatry Physician	$0	$3.4M

Saint Clare Hospital — Billing Profile & Reimbursement Data

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Saint Clare 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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