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.

Express Care Wa PC (NPI 1821554452)

Express Care Wa PC is a general practice physician provider located in Lacey, Washington. This profile covers 0 Medicare and 14 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	Express Care Wa PC
Address	1350 Marvin Rd Ne Ste D
City	Lacey
State	WA
ZIP	98516
Taxonomy	General Practice Physician
NPI Enumerated	February 19, 2019

Payer Source	Total Paid
Medicaid	$5.4M
Medicare	$0

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

14 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…	52,520	$60	$3.2M
99203	The provider sees a new 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 provider…	14,390	$80	$1.2M
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	8,520	$50	$451.4K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	6,180	$30	$203.9K
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…	1,990	$80	$167.2K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	1,220	$90	$104.7K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	750	$50	$38.1K
99204	The provider sees a new 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 provider…	230	$120	$27.5K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	360	$30	$11.9K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	290	$40	$10.6K

Showing 1–10 of 14

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

Express Care Wa PC — 2 of 14 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

14 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…	511	1,820	480	$60	$379.6K
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…	57	1,860	610	$40	$295.5K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	18	210	690	$40	$114.5K
99203	The provider sees a new 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 provider…	11	560	140	$70	$88.9K
99204	The provider sees a new 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 provider…	182	530	80	$90	$87.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	254	700	180	$50	$59.3K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	6	80	360	$30	$49.9K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	23	100	290	$50	$49.2K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	45	250	110	$60	$41.6K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	76	160	260	$20	$23.4K

Showing 1–10 of 14

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dennis Ang	WA	Nurse Practitioner	$151.1K	$0
Denise Tran	AK	Family Nurse Practitioner	$80.2K	$0
Jonathan Lippman	ID	Physician Assistant	$73K	$0
Lara Lawlor	AK	Family Nurse Practitioner	$53.5K	$0
Geraldine Cabero	WA	Physician Assistant	$43.4K	$0
Elise Bishop	AK	Family Nurse Practitioner	$41.5K	$0
John Rogers	WA	Family Nurse Practitioner	$39.9K	$0
Brandy Zerby	OR	Medical Physician Assistant	$30.8K	$0
Jebb Sagun	AK	Family Nurse Practitioner	$28.9K	$0
Oivind Westereng	MT	Physician Assistant	$26K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Evergreen Treatment Services Unit 5	WA	Methadone Clinic	$275.3K	$12.5M
Geneva Woods Health Supplies Pnw, LLC	WA	Durable Medical Equipment & Medical Supplies	$0	$11M
Evergreen Treatment Services	WA	Methadone Clinic	$0	$8M
Lincare Inc.	WA	Durable Medical Equipment & Medical Supplies	$0	$4.3M
Pacific Cataract And Laser Institute, Inc., P.C.	WA	Ambulatory Surgical Clinic/Center	$995.7K	$242.5K
Hawks Prairie Pharmacy	WA	Pharmacy	$210.8K	$0
Robert Widrow	WA	Internal Medicine Physician	$111.1K	$0
Benjamin Matthews	WA	Family Nurse Practitioner	$109.3K	$0
Jared Bruce	WA	General Practice Physician	$95.5K	$0
Emily Clay	WA	Family Medicine Physician	$57.6K	$0

Express Care Wa PC — Billing Profile & Reimbursement Data

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Express Care Wa PC — 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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