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.

Sunnyside Community Hospital Association (NPI 1841639119)

Sunnyside Community Hospital Association is a rural health clinic/center provider located in Sunnyside, Washington. This profile covers 0 Medicare and 29 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	Sunnyside Community Hospital Association
Address	2705 E Lincoln Ave
City	Sunnyside
State	WA
ZIP	98944
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	June 20, 2013

Payer Source	Total Paid
Medicaid	$4.4M
Medicare	$0

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

29 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	22,400	$150	$3.3M
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…	10,490	$50	$524.5K
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…	1,780	$60	$112K
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…	1,050	$100	$109.6K
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,…	2,980	$40	$107.4K
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…	1,570	$60	$94.4K
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…	1,710	$40	$75K
31231	In this procedure, the provider inserts an endoscope into the nasal cavity to examine the structures of the nasal cavity on one or both sides.	240	$110	$26.1K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	1,590	$10	$19.1K
99205	The provider sees a new 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 provider…	150	$100	$14.7K

Showing 1–10 of 29

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

Sunnyside Community Hospital Association — 0 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

29 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	144	650	4,110	$250	$4.9M
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…	543	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…	237	1,860	610	$40	$295.5K
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…	368	540	130	$90	$128.6K
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…	95	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…	77	530	80	$90	$87.4K
90961	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the…	24	30	720	$50	$83.9K
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	33	40	650	$50	$79.6K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	38	50	310	$70	$74.7K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	39	50	700	$30	$72.2K

Showing 1–10 of 29

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sunnyside Community Hospital Association	WA	Critical Access Hospital	$0	$55.1M
Marion Area Physicians LLC	OH	Internal Medicine Physician	$0	$15.7M
Shc Medical Center Toppenish	WA	General Acute Care Hospital	$0	$15.1M
Sunnyside Community Hospital Association	WA	Rural Health Clinic/Center	$0	$7M
Sunnyside Community Hospital Association	WA	Rural Health Clinic/Center	$0	$5.8M
Sunnyside Community Hospital Association	WA	Rural Health Clinic/Center	$0	$2.8M
Danko Martincic	ID	Hematology & Oncology Physician	$2.6M	$0
Belmond Community Hospital	IA	Rural Health Clinic/Center	$0	$1.9M
Nicholas Kalayeh	NV	Interventional Cardiology Physician	$573.7K	$88.4K
Tatiana Antoci	RI	Family Medicine Physician	$95.7K	$349.7K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Thompson Dmd PLLC	WA	Dentist	$0	$36.6M
Total Renal Care Inc	WA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$6.1M
Swofford & Halma Clinic, Inc. P.s.	WA	Family Medicine Physician	$0	$5.4M
Mid-valley Community Clinic, PLLC	WA	Family Medicine Physician	$0	$4.4M
Thompson.ferguson.steinhart.james.leavitt,pllc	WA	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$4.2M
Sunnyside Emergency Group A Professional LLC	WA	Emergency Medicine Physician	$0	$3.8M
Derek S Weaver Do PLLC	WA	Family Medicine Physician	$0	$2.6M
B Martin And G Martin PLLC	WA	Dentist	$0	$2.6M
Greg Norell, Dds	WA	General Practice Dentistry	$0	$2.5M
City Of Sunnyside	WA	Land Ambulance	$221.9K	$672.8K

Sunnyside Community Hospital Association — Billing Profile & Reimbursement Data

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Sunnyside Community Hospital Association — 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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