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.

Providence Health & Services - Washington (NPI 1699926402)

Field	Value
Entity Type	Organization
Organization	Providence Health & Services - Washington
Address	401 W Poplar St
City	Walla Walla
State	WA
ZIP	99362
Taxonomy	Emergency Medicine Physician
NPI Enumerated	October 10, 2008

Payer Source	Total Paid
Medicaid	$4.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	27,670	$70	$1.9M
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.	13,710	$90	$1.2M
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.	28,160	$40	$1.2M
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.	10	$370	$5.1K
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.	90	$40	$3.2K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	10	$100	$1.1K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	100	$10	$820
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	30	$30	$780
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	30	$20	$620
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	20	$20	$290

Showing 1–10 of 18

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

Providence Health & Services - Washington — 0 of 12 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

18 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	104	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.	55	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.	49	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.	68	190	5,130	$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.	119	140	2,410	$110	$593.3K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	173	240	2,430	$10	$194.2K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	462	480	1,160	$30	$180.9K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	123	130	290	$90	$138.1K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	102	110	6,380	$10	$117.4K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	203	270	2,880	$1	$100.6K

Showing 1–10 of 18

Related Providers

Other providers that share a Tax Identification Number (TIN) with Providence Health & Services - Washington, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Providence Health & Services - Washington	WA	Critical Access Hospital	$0	$26.8M
Providence Health & Services - Washington	WA	General Acute Care Hospital	$0	$17.3M
Providence Health & Services - Washington	WA	Family Medicine Physician	$0	$7.6M
Providence Health & Services - Washington	WA	Family Medicine Physician	$0	$2.9M
Bryan Ager	WA	Radiation Oncology Physician	$812.1K	$0
Daryl Sudasena	WA	Interventional Cardiology Physician	$380.6K	$0
Joanne Lynn Perez	WA	Internal Medicine Physician	$332.6K	$0
Suwong Wongsuwan	WA	Cardiovascular Disease Physician	$329.4K	$0
Jon Gardner	WA	Internal Medicine Physician	$291.5K	$0
Howard Sill	MD	Vascular & Interventional Radiology Physician	$216.3K	$170

Nearby Providers

Other providers in the same ZIP code as Providence Health & Services - Washington, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Privia Medical Group Washington, PLLC	WA	Rural Health Clinic/Center	$0	$19M
Yakima Valley Farm Workers Clinic	WA	Federally Qualified Health Center (FQHC)	$0	$9.3M
Jonathan Gantz	WA	General Practice Dentistry	$0	$4.7M
City Of Walla Walla	WA	Land Ambulance	$527.2K	$4.1M
Yakima Valley Farm Workers Clinic	WA	Federally Qualified Health Center (FQHC)	$0	$3.7M
Privia Medical Group Washington, PLLC	WA	Clinic/Center	$0	$2.8M
Norco, Inc	WA	Durable Medical Equipment & Medical Supplies	$0	$2.5M
David Panther	WA	Dermatology Physician	$762.5K	$0
Andrew Edwards	WA	Ophthalmology Physician	$698.5K	$0
Walla Walla Clinic, Inc.	WA	Ambulatory Surgical Clinic/Center	$414.6K	$0

Providence Health & Services - Washington — Billing Profile & Reimbursement Data

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Providence Health & Services - Washington — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References