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 Missouri for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Missouri 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. Missouri (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.

Washington University (NPI 1760422265)

Washington University is a multi-specialty clinic/center provider located in Saint Louis, Missouri. This profile covers 0 Medicare and 23 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	Washington University
Address	660 S Euclid Ave
City	Saint Louis
State	MO
ZIP	63110
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	June 7, 2006

Payer Source	Total Paid
Medicaid	$4M
Medicare	$0

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

23 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…	23,660	$60	$1.3M
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	390	$960	$369.8K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	9,030	$40	$324.9K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	3,100	$100	$312.6K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	8,600	$30	$292.4K
76817	The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.	7,350	$40	$279.4K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	5,130	$40	$195K
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	1,980	$90	$171.8K
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…	2,080	$80	$170.3K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	4,170	$40	$158.5K

Showing 1–10 of 23

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Missouri providers billing the same CPT/HCPCS codes.

Claims Volume vs. Missouri Distribution

Washington University — 10 of 22 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

23 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	434	3,170	230	$70	$128.1K
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…	389	590	260	$40	$120.5K
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…	66	4,310	300	$60	$110.8K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	8	190	270	$70	$91.4K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	4	70	300	$110	$81.2K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	4	40	30	$700	$78.8K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	6	80	280	$50	$60.3K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	2	180	150	$70	$51K
76817	The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.	2	90	170	$60	$42.5K
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	10	60	280	$50	$35.4K

Showing 1–10 of 23

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Washington University	MO	Multi-Specialty Clinic/Center	$0	$22M
Washington University	MO	Multi-Specialty Clinic/Center	$0	$14.8M
Washington University	MO	Multi-Specialty Clinic/Center	$0	$10.4M
Southern Illinois Healthcare Foundation, Inc.	IL	Federally Qualified Health Center (FQHC)	$0	$9.8M
Washington University	MO	Emergency Care Clinic/Center	$0	$9.1M
Washington University	MO	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$6.9M
Washington University	MO	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.4M
John Visconti	IL	Medical Oncology Physician	$2.8M	$149.1K
Peter Oppelt	MO	Medical Oncology Physician	$2.5M	$15.8K
Ronald Dean	MT	Emergency Medicine Physician	$2.3M	$2.3K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Council For Extended Care	MO	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$98.1M
St. Louis Children's Hospital	MO	Children's Hospital	$0	$66.9M
Barnes Jewish Hospital	MO	General Acute Care Hospital	$0	$61.4M
Paraquad Inc	MO	Customized Equipment (DME)	$0	$56.3M
Cooperative Home Care, Inc.	MO	Home Health Agency	$0	$20.6M
New Beginnings In Home Services, LLC	MO	In Home Supportive Care Agency	$0	$11.6M
Bjc Home Care Services	MO	Durable Medical Equipment & Medical Supplies	$0	$8.2M
Wallace Family In Home Health LLC	MO	In Home Supportive Care Agency	$0	$6.6M
Cooperative Home Care	MO	Home Health Agency	$0	$5.5M
Josephines Caring Hands	MO	In Home Supportive Care Agency	$0	$3.4M

Washington University — Billing Profile & Reimbursement Data

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Washington University — 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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