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.

Public Hospital District No 1 Of Mason County (NPI 1760568752)

Key Findings

Field	Value
Entity Type	Organization
Organization	Public Hospital District No 1 Of Mason County
Address	901 Mt View Dr
City	Shelton
State	WA
ZIP	98584
Taxonomy	Critical Access Hospital
NPI Enumerated	October 31, 2006

Payer Source	Total Paid
Medicaid	$72.3M
Medicare	$0

This provider effectively operates on a single-payer Medicaid footprint: there is no Medicare billing on file while reported Medicaid revenue totals $72.3M, so Medicaid accounts for the entirety of recorded programmatic revenue in this dataset. Analysts should treat Medicaid patterns as the primary driver of volume and financial risk for this entity.

Revenue concentration is high and ED-focused: the precomputed top three Medicaid codes (99284, 99283, 99285) together account for 45.4% of this provider's total Medicaid revenue. That concentration indicates a small set of emergency department E/M services is responsible for nearly half of Medicaid payments to the hospital.

The code mix aligns with an acute, ED-centric Critical Access Hospital model: 99284, 99283, and 99285 are the top revenue drivers (moderate-, low- and high-level ED E/M), and sizable payments for observation G0378 ($4.5M, 8.6%) and CT abdomen/pelvis 74177 ($4.9M, 9.3%) show the hospital pairs emergency care with observation and advanced diagnostic imaging. Together these codes suggest the facility supports substantial unscheduled/emergent care plus downstream observation and imaging resources.

Competitive standing within Washington state shows a strong presence in lower- and mid-acuity ED care but less dominance at the highest-acuity ED level: 99283 ranks #27 of 234 providers in-state (89th percentile) and 99284 ranks #39 of 225 (83rd percentile), while 99285 ranks #73 of 192 (62nd percentile). In plain comparative terms the provider is an above-average contributor for low-to-moderate ED visits statewide but only a mid-range participant for the highest-acuity ED visits.

Secondary revenue streams are material and reflect diagnostic and observation capacity: 74177 generates $4.9M (9.3% of Medicaid revenue) and G0378 generates $4.5M (8.6% of Medicaid revenue). These two codes are clear secondary revenue contributors and indicate the hospital’s revenue is not solely E/M-driven but also supported by imaging and observation services.

High-volume, routine outpatient services reinforce substantial throughput: the dataset shows large claim counts for routine procedures and therapies — 36415 (59.5K claims, $1.1M; ranks #21 of 552, 96th percentile), 97110 (21.3K claims, $1.2M; ranks #32 of 476, 93rd percentile), and 97530 (14K claims, $1.5M; ranks #56 of 591, 91st percentile). Each of these codes is described in the comparative data as "typical, unremarkable volume for this code," but the raw claim counts and high percentiles point to substantial outpatient and ancillary throughput supporting Medicaid revenue.

Tenure: the provider’s NPI was enumerated on 2006-10-31 (~20 years ago), indicating an established local presence. For competitive analysis and network contracting this longevity, combined with the Medicaid concentration and ED-heavy case mix, suggests this is a stable regional access point for emergency and diagnostic services.

From a payer-strategy perspective, contracting or utilization-management initiatives should prioritize ED and observation pathways given their outsized revenue roles — 99284/99283/99285 together represent 45.4% of Medicaid revenue — while also accounting for significant diagnostic imaging (e.g., 74177) and high-volume outpatient services that drive visit throughput and ancillary spend.

Medicaid: Complete Services Breakdown

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

311 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.	39,030	$220	$8.7M
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.	45,520	$190	$8.6M
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.	12,320	$530	$6.6M
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.	3,700	$1,330	$4.9M
G0378	Hospital observation service, per hour	5,210	$870	$4.5M
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.	14,390	$140	$2M
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.	3,630	$520	$1.9M
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.	1,750	$1,040	$1.8M
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.	14,020	$110	$1.5M
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…	21,250	$60	$1.2M

Showing 1–10 of 311

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

Public Hospital District No 1 Of Mason County — 1 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

311 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	523	650	4,110	$250	$4.9M
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.	47	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.	39	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.	27	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.	73	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.	58	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.	50	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.	47	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.	56	70	2,010	$210	$620.1K
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.	14	140	2,410	$110	$593.3K

Showing 1–10 of 311

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Public Hospital District No 1 Of Mason County	WA	Rural Health Clinic/Center	$0	$35.5M
Public Hospital District No 1 Of Mason County	WA	Rural Health Clinic/Center	$0	$3.9M
Public Hospital District No 1 Of Mason County	WA	Rural Health Clinic/Center	$0	$3.8M
Ryan Halpin	WA	Neurological Surgery Physician	$756.1K	$0
Andrew Manista	WA	Orthopaedic Surgery Physician	$454.4K	$0
Darrin Trask	WA	Orthopaedic Surgery Physician	$241.1K	$0
Ross Vogelgesang	WA	Pain Medicine (Anesthesiology) Physician	$228.8K	$0
Jerome Zechmann	WA	Orthopaedic Surgery Physician	$214K	$0
Yong Shin	WA	Internal Medicine Physician	$208.3K	$0
Milan Moore	WA	Orthopaedic Surgery Physician	$181.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northwest Indian Treatment Center	WA	Clinic/Center	$0	$17.3M
Fire Protection Dist 5 Mason County	WA	Land Ambulance	$766.4K	$6.9M
Squaxin Island Medical Encounter	WA	Health Service Clinic/Center	$0	$4.6M
Northwest Resources Ii	WA	Addiction (Substance Use Disorder) Counselor	$0	$3.9M
Squaxin Island Tribe	WA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$3.8M
Skokomish Tribal Council	WA	Family Medicine Physician	$0	$3.1M
Patrick Kwong	WA	General Practice Dentistry	$0	$2.5M
Gregory Fulling	WA	Physical Therapist	$65.8K	$0
Edward Herman	WA	Clinical Social Worker	$27K	$0

Public Hospital District No 1 Of Mason County — 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