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.

Franciscan Medical Group (NPI 1710432612)

Franciscan Medical Group is a internal medicine physician provider located in Silverdale, Washington. This profile covers 0 Medicare and 96 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	Franciscan Medical Group
Address	2200 Nw Myhre Rd
City	Silverdale
State	WA
ZIP	98383
Taxonomy	Internal Medicine Physician
NPI Enumerated	August 20, 2016

Payer Source	Total Paid
Medicaid	$7.7M
Medicare	$0

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

96 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	44,480	$60	$2.4M
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…	32,140	$60	$2M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	9,130	$90	$849.3K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	6,710	$100	$684K
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…	4,040	$80	$339.6K
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…	4,090	$60	$261.5K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	1,640	$70	$108.1K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	5,540	$20	$94.1K
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…	3,140	$30	$91.1K
J0585	Injection, onabotulinumtoxina, 1 unit	90	$870	$82.1K

Showing 1–10 of 96

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

Franciscan Medical Group — 5 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

96 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0585	Injection, onabotulinumtoxina, 1 unit	30	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…	66	1,820	480	$60	$379.6K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	100	130	890	$100	$337.8K
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…	68	1,860	610	$40	$295.5K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	68	120	640	$100	$259.3K
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.	493	590	1,280	$50	$244.5K
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…	169	480	1,160	$30	$180.9K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	24	280	540	$70	$166.5K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	29	300	400	$80	$164.4K
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…	336	540	130	$90	$128.6K

Showing 1–10 of 96

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Franciscan Medical Group	WA	Family Medicine Physician	$0	$92.6M
Franciscan Health System	WA	General Acute Care Hospital	$0	$44.6M
Valley Medical Group-renton	WA	General Acute Care Hospital	$0	$28.3M
Multicare Health System	WA	Family Medicine Physician	$0	$25.8M
Franciscan Health System	WA	Internal Medicine Physician	$0	$6.4M
Pacmed Clinics	WA	Multi-Specialty Clinic/Center	$0	$4.5M
Franciscan Medical Group	WA	Internal Medicine Physician	$0	$4.5M
Franciscan Health System	WA	Durable Medical Equipment & Medical Supplies	$0	$2.7M
Manoj Agarwal	WA	Medical Oncology Physician	$1M	$0
Daniel Kim	WA	Rheumatology Physician	$1M	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Commonspirit Washington Community Care	WA	General Acute Care Hospital	$0	$66.2M
Central Kitsap Fire & Rescue 1	WA	Land Ambulance	$727.8K	$11M
West Sound Emergency Physicians, PLLC	WA	Emergency Medicine Physician	$0	$8.3M
David Spinak	WA	Ophthalmology Physician	$4.1M	$0
Mark Heinemann	WA	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$3.3M
Easter Seals Washington	WA	Community/Behavioral Health Agency	$0	$3.3M
Adrian Omalley	WA	Ophthalmology Physician	$3M	$0
Salmon Surgery Center LLC	WA	Ambulatory Surgical Clinic/Center	$2.3M	$44.3K
Todd Schneiderman	WA	Ophthalmology Physician	$2.3M	$0
Surgery Center Of Silverdale LLC	WA	Ambulatory Surgical Clinic/Center	$1.5M	$0

Franciscan Medical Group — 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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