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NPI 1740211028 · Elma, WA · Critical Access Hospital
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Grays Harbor County Public Hospital District No 1 is a critical access hospital provider located in Elma, Washington. This profile covers 0 Medicare and 244 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Grays Harbor County Public Hospital District No 1 |
| Address | 600 E. Main Street |
| City | Elma |
| State | WA |
| ZIP | 98541 |
| Taxonomy | Critical Access Hospital |
| NPI Enumerated | July 5, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $50.1M |
| Medicare | $0 |
This provider is effectively a single‑payer Medicaid facility: Total Medicare revenue is none and Total Medicaid revenue is $50.1M, so all billed fee‑for‑service activity on file is Medicaid-based. That payer concentration means analyses of utilization and revenue risk should focus on Medicaid policy and local managed‑care contracting rather than traditional Medicare dynamics.
Revenue concentration is high: the precomputed top three Medicaid codes account for 49.5% of total Medicaid revenue, driven by 99283 ($8.6M, 21.6%), 74177 ($6M, 14.9%), and 99284 ($5.2M, 13.0%). This level of concentration implies that changes in ED throughput or imaging utilization for these specific services would meaningfully move overall Medicaid revenue.
The code mix indicates an ED-centric, imaging‑enabled critical access operation. Multiple emergency department E/M codes — 99283, 99284, 99285, and 99282 — are among the top revenue drivers, while high‑revenue imaging codes such as 74177 (CT abdomen/pelvis with contrast) and 74176 (CT without contrast) point to in‑house CT capability supporting acute diagnostics.
Competitive standing versus in‑state peers is mixed by service line: 99283 ranks #15 of 234 providers in-state (94th percentile; typical, unremarkable volume), 74177 ranks #54 of 139 (62th percentile; typical, unremarkable volume), and 99284 ranks #74 of 225 (67th percentile; typical, unremarkable volume). In aggregate this places the provider as a meaningful, but not dominant, Medicaid player for major ED presentations and abdominal CTs in Washington.
Several codes are statistical outliers in state comparisons, signaling distinctive service patterns. The provider is an extreme outlier on 80305 (rank #2 of 221, 100th percentile; extreme outlier), and reports notably above‑typical volumes for 99282 (rank #8 of 144, 95th percentile; notably above typical) and 87804 (rank #9 of 247, 97th percentile; notably above typical), which together indicate unusually high volumes of presumptive drug testing, low‑acuity ED visits, and rapid influenza testing compared with peers.
Operationally, the per‑claim reimbursement profile underscores why imaging and ED E/Ms drive revenue: 74177 pays $1461 avg paid/claim (4.1K claims, $6M revenue), 99284 pays $249 avg paid/claim (20.8K claims, $5.2M revenue), and 99283 pays $145 avg paid/claim (59.6K claims, $8.6M revenue). Those contrasts show that relatively high unit payments for CT imaging and high volumes of ED E/Ms both contribute materially to the $50.1M Medicaid revenue base.
The provider’s taxonomy and tenure align with a stable rural safety‑net role: listed as a Critical Access Hospital and NPI enumerated on 2006-07-05 (~20 years ago). Combined with the heavy ED, imaging, infusion (e.g., 96374, 96365) and lab testing footprint, the profile is consistent with a long‑standing local hospital delivering 24/7 acute services and ancillary diagnostics to a Medicaid population.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
244 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 59,580 | $150 | $8.6M |
| 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. | 4,080 | $1,460 | $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. | 20,810 | $250 | $5.2M |
| 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. | 6,850 | $530 | $3.7M |
| 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. | 22,160 | $100 | $2.2M |
| 74176 | The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 1,880 | $1,010 | $1.9M |
| 96374 | The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition. | 7,820 | $180 | $1.4M |
| 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. | 2,580 | $480 | $1.2M |
| 71046 | In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and… | 7,860 | $140 | $1.1M |
| 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. | 4,890 | $200 | $968.2K |
Showing 1–10 of 244
How this provider's Medicaid billing volume and revenue compare to other Washington providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Washington median
244 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 585 | 650 | 4,110 | $250 | $4.9M |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 83 | 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. | 58 | 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. | 74 | 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. | 15 | 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. | 92 | 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. | 54 | 140 | 2,830 | $150 | $1.1M |
| 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. | 72 | 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. | 41 | 100 | 3,660 | $100 | $635.7K |
| 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. | 38 | 70 | 2,010 | $210 | $620.1K |
Showing 1–10 of 244
Other providers in the same ZIP code as Grays Harbor County Public Hospital District No 1, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Northwest Indian Treatment Center | WA | Substance Abuse Rehabilitation Facility | $0 | $30.5M |
| Sea Mar Community Health Centers | WA | Federally Qualified Health Center (FQHC) | $0 | $3.5M |
| Jamie Graves | WA | Physical Therapist | $63K | $0 |
| Laura Brownsmith | WA | Family Nurse Practitioner | $21.4K | $0 |
| Sonya Goodin | WA | Family Nurse Practitioner | $3.2K | $0 |
| Edward Gonzalez | WA | Family Nurse Practitioner | $1.7K | $0 |
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