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.

Optum Care Washington PLLC (NPI 1831186766)

Field	Value
Entity Type	Organization
Organization	Optum Care Washington PLLC
Address	3901 Hoyt Ave
City	Everett
State	WA
ZIP	98201
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	October 5, 2005

Payer Source	Total Paid
Medicaid	$19.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

219 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	146,830	$60	$8.4M
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…	85,590	$50	$4.5M
J0585	Injection, onabotulinumtoxina, 1 unit	1,410	$760	$1.1M
U0004	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…	15,570	$60	$996.2K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	8,500	$90	$798.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5,720	$90	$532.1K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	4,810	$80	$403.8K
U0002	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	7,510	$40	$307.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	4,550	$60	$259.4K
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…	10,620	$20	$212.4K

Showing 1–10 of 219

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

Optum Care Washington PLLC — 3 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

219 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	Injection, pembrolizumab, 1 mg	14	10	270	$3,820	$2.9M
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.	131	140	2,830	$150	$1.1M
U0004	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…	3	10	3,400	$70	$683.2K
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.	94	100	3,660	$100	$635.7K
J0585	Injection, onabotulinumtoxina, 1 unit	15	40	1,040	$390	$518.8K
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…	14	1,820	480	$60	$379.6K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	39	130	890	$100	$337.8K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	95	120	590	$230	$331.2K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	18	60	2,360	$70	$330.6K
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…	32	1,860	610	$40	$295.5K

Showing 1–10 of 219

Related Providers

Other providers that share a Tax Identification Number (TIN) with Optum Care Washington PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tulalip Tribes Of Washington	WA	General Practice Physician	$0	$21.6M
Tulalip Tribes Of Washington	WA	Substance Use Disorder Rehabilitation Clinic/Center	$0	$15.7M
Tulalip Tribes Of Washington	WA	Dentist	$0	$7.8M
Tulalip Tribes Of Washington	WA	Public Health & General Preventive Medicine Physician	$0	$4M
Tulalip Tribes Of Washington	WA	Public Health & General Preventive Medicine Physician	$0	$3.8M
Optum Care Washington PLLC	WA	Ambulatory Surgical Clinic/Center	$1.7M	$937.1K
Rafal Sosnowski	IL	Diagnostic Radiology Physician	$1.7M	$75.2K
Richard Roberts	TN	Anatomic Pathology & Clinical Pathology Physician	$1.3M	$790
Zhihong Zhang	WA	Hematology & Oncology Physician	$1.1M	$0
Paul Mcbride	WA	Allergy & Immunology Physician	$809.9K	$0

Nearby Providers

Other providers in the same ZIP code as Optum Care Washington PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Health Center Of Snohomish County	WA	Dentist	$0	$112.1M
Providence Health & Services-wa	WA	General Acute Care Hospital	$0	$62.4M
Sunrise Services, Inc.	WA	Community/Behavioral Health Agency	$0	$21.4M
North Sound Emergency Medicine PC	WA	Emergency Medicine Physician	$0	$8.7M
Catholic Community Services Western Washington	WA	Substance Use Disorder Rehabilitation Clinic/Center	$0	$7.9M
Providence Health & Services- Washington	WA	General Practice Physician	$0	$7.6M
Assured Independence, LLC	WA	Emergency Response System Companies	$0	$7M
Pioneer Human Services	WA	Substance Abuse Rehabilitation Facility	$0	$6.2M
Evergreen Recovery Centers	WA	Substance Use Disorder Rehabilitation Clinic/Center	$0	$5.9M
Sight Partners	WA	Ambulatory Surgical Clinic/Center	$4.9M	$342.1K

Optum Care Washington PLLC — Billing Profile & Reimbursement Data

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Optum Care Washington PLLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References