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

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

Tri-city Hospital (NPI 1801861190)

Field	Value
Entity Type	Organization
Organization	Tri-city Hospital
Address	4002 Vista Way
City	Oceanside
State	CA
ZIP	92056
Taxonomy	General Acute Care Hospital
NPI Enumerated	February 21, 2006

Payer Source	Total Paid
Medicaid	$44.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

267 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
0450	N/A	50,240	$240	$12.1M
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.	25,300	$150	$3.7M
99499	Use 99499 to report evaluation and management services for which there is no specific code available.	12,940	$210	$2.7M
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	56,530	$40	$2.4M
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	16,960	$60	$1M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	9,200	$110	$965.5K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	9,670	$100	$938.1K
J3490	Unclassified drugs	26,660	$40	$933.1K
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.	7,560	$120	$915.2K
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.	4,980	$170	$825.9K

Showing 1–10 of 267

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. California Distribution

Tri-city Hospital — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. California median

267 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
0450	N/A	142	450	16,140	$90	$3.6M
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	326	390	1,270	$220	$1.5M
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.	195	1,570	680	$110	$1.1M
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.	411	1,300	510	$100	$943K
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.	446	1,400	470	$80	$884.5K
0510	N/A	207	230	930	$40	$854K
99281	The provider sees a patient for the lowest level emergency department visit.	225	430	1,140	$90	$769.9K
G0378	Hospital observation service, per hour	131	200	550	$310	$605.9K
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	191	530	990	$120	$588.5K
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.	196	780	1,160	$130	$576.2K

Showing 1–10 of 267

Nearby Providers

Other providers in the same ZIP code as Tri-city Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Luis Navazo	CA	Family Medicine Physician	$2M	$0
Jens Thiele	CA	Dermatology Physician	$1.4M	$800
North Coast Surgery Center Ltd	CA	Ambulatory Surgical Clinic/Center	$1.4M	$0
Jason Curry	CA	Physical Medicine & Rehabilitation Physician	$499.1K	$0
Casey Fisher	CA	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$381.4K	$0
Jeffrey Miller	CA	Diagnostic Radiology Physician	$313.8K	$0
Nayyar Siddique	CA	Hematology & Oncology Physician	$266.6K	$0
Jason Phillips	CA	Urology Physician	$250.4K	$0
Alina Goldenberg	CA	Dermatology Physician	$239.2K	$0
Michael Guerena	CA	Specialist	$222.4K	$0

Tri-city Hospital — Billing Profile & Reimbursement Data

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Tri-city Hospital — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References