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.

Multicare Health System (NPI 1730687161)

Key Findings

Field	Value
Entity Type	Organization
Organization	Multicare Health System
Address	400 E 5th Ave
City	Spokane
State	WA
ZIP	99202
Taxonomy	Internal Medicine Physician
NPI Enumerated	January 31, 2018

Payer Source	Total Paid
Medicaid	$46.6M
Medicare	$0

This provider is effectively single-payer in the public program mix: Medicare billing is recorded as none (no Medicare billing on file) while Medicaid is the sole reported public payer driving $46.6M in lifetime revenue. The absence of Medicare activity indicates the facility’s public program exposure and contracting focus is concentrated on Medicaid populations rather than traditional Medicare fee-for-service lines.

Revenue is highly concentrated in a small set of evaluation-and-management codes: the top three Medicaid codes (99214, 99213, 99215) together account for 63.1% of the provider’s Medicaid revenue. Those codes individually represent $15.6M (99214, 37.6%), $8.7M (99213, 21.1%), and $1.8M (99215, 4.4%) of the $46.6M total, signaling that outpatient office visits are the primary revenue drivers.

The code mix and volumes point to a high-throughput ambulatory/internal medicine footprint. 99214 has 225.4K claims and 99213 has 158.3K claims, paired with the provider taxonomy of Internal Medicine Physician, which together indicate routine management of established patients in high volume rather than a narrow procedural specialty.

Beyond primary E/M, the Medicaid claims portfolio shows a broad ambulatory and procedural scope suggesting multi‑specialty services within the system: notable lines include ophthalmology (92004, $899.4K), therapeutic exercise/physical therapy (97110, $1.2M; 97140, $404.9K), endoscopy/biopsy (43239, $416.4K), and colonoscopic intervention (45385, $272.6K). The presence of high-cost injectable drugs (J0585 $1.4M; J0178 $562.7K) further supports a mixed outpatient procedural and infusion/injection capability.

Competitive standing in-state for core visit-level codes is dominant: 99214 ranks #10 of 1823 providers in-state at the 100th percentile and is labeled an "extreme outlier," 99213 ranks #12 of 1863 at the 99th percentile ("extreme outlier"), and 99215 ranks #10 of 536 at the 98th percentile ("extreme outlier"). Several preventive and ancillary codes also show outsized statewide volumes (for example, 92004 ranks #3 of 581 at the 100th percentile and 90686 ranks #12 of 584 at the 98th percentile), indicating the provider is a major in-state volume competitor across multiple ambulatory service lines.

The provider reports meaningful hospital-based and higher-acuity activity alongside outpatient care: inpatient/observation follow-up and initial hospital care codes (99232 $874.2K, 99233 $528.9K, 99223 $246.4K) and critical care (99291 $493.9K) all appear in the top code list, demonstrating that the organization performs both outpatient continuity care and inpatient/acute services under Medicaid. This mix reinforces an integrated system that spans ambulatory, inpatient, and procedural care.

Preventive services constitute a substantial, visible component of the Medicaid portfolio: 99392 ($1.7M, 4.1%), 99391 ($1.7M, 4.0%), 99393 ($1.4M, 3.3%), and 99394 ($525K, 1.3%) are all high-volume and rank in upper percentiles statewide (several listed as 98–99th percentiles and labeled "extreme outlier"), indicating systematic delivery of routine wellness and pediatric/adolescent well‑care visits. This pattern suggests population-health and preventive visit capacity that likely supports ongoing primary care panels.

The provider’s NPI was enumerated on 2018-01-31 (~8 years ago), giving it several years of active Medicaid reporting to generate the high claim volumes observed. The tenure is sufficient to support the scale reflected in the 225.4K claims for 99214 and the other sustained high-volume codes, implying established operational capacity rather than a short-term spike in activity.

Medicaid: Complete Services Breakdown

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

327 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…	225,380	$70	$15.6M
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…	158,280	$60	$8.7M
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…	19,070	$100	$1.8M
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…	17,390	$100	$1.7M
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…	18,410	$90	$1.7M
J0585	Injection, onabotulinumtoxina, 1 unit	2,130	$680	$1.4M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	14,560	$100	$1.4M
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…	38,430	$30	$1.2M
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	9,880	$90	$899.4K
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…	23,630	$40	$874.2K

Showing 1–10 of 327

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

Multicare Health System — 14 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

327 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	122	140	2,830	$150	$1.1M
J0178	Injection, aflibercept, 1 mg	14	30	550	$930	$892.3K
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.	87	100	3,660	$100	$635.7K
J0585	Injection, onabotulinumtoxina, 1 unit	8	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…	10	1,820	480	$60	$379.6K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	35	40	1,080	$70	$362.2K
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…	30	130	890	$100	$337.8K
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.	4	120	590	$230	$331.2K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	46	60	2,360	$70	$330.6K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	26	30	110	$740	$316.7K

Showing 1–10 of 327

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Frontier Behavioral Health	WA	Community/Behavioral Health Agency	$0	$34.3M
Dungarvin Washington Children's Services, LLC	WA	Developmental Disabilities Clinic/Center	$0	$21.3M
Community Health Association Of Spokane	WA	Federally Qualified Health Center (FQHC)	$0	$8.2M
Providence Health & Services- Washington	WA	Rehabilitation Hospital	$0	$8M
Compass Career Solutions LLC	WA	Developmentally Disabled Services Day Training Agency	$0	$7.7M
Inland Imaging LLC	WA	Diagnostic Radiology Physician	$0	$6.8M
Northwest Autism Center	WA	Community/Behavioral Health Agency	$0	$5.9M
Northwest Pediatric Ophthalmology	WA	Ophthalmology Physician	$0	$4.2M
Inland Northwest Renal Care Group, LLC	WA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.1M
Collin Perri	WA	Physician Assistant	$3.8M	$0

Multicare Health System — Billing Profile & Reimbursement Data

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Multicare Health System — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Multicare Health System	WA	General Acute Care Hospital	$0	$162.2M
Multicare Health System	WA	Children's Hospital	$0	$108.4M
Multicare Health System	WA	General Acute Care Hospital	$0	$77.8M
Multicare Health System	WA	Family Medicine Physician	$0	$75M
Multicare Health System	WA	General Acute Care Hospital	$0	$55.1M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Multicare Health System	WA	Community/Behavioral Health Agency	$0	$48.2M
Multicare Health System	WA	General Acute Care Hospital	$0	$30.9M
Multicare Health System	WA	Pediatrics Physician	$0	$29.4M
Multicare Health System	WA	Family Medicine Physician	$0	$25.8M