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.

Shc Medical Center Toppenish (NPI 1851817308)

Shc Medical Center Toppenish is a general acute care hospital provider located in Toppenish, Washington. This profile covers 0 Medicare and 239 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	Shc Medical Center Toppenish
Address	502 W 4th Ave
City	Toppenish
State	WA
ZIP	98948
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 16, 2017

Payer Source	Total Paid
Medicaid	$15.1M
Medicare	$0

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

239 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	35,790	$120	$4.2M
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.	9,150	$300	$2.7M
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.	22,540	$90	$2.1M
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.	7,290	$110	$773K
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.	3,380	$180	$605.2K
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.	7,840	$70	$548.7K
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.	3,060	$150	$465.6K
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.	4,870	$80	$409.2K
96360	The provider introduces a catheter intravenously for supplementation of fluid and electrolytes for 31 minutes to one hour to treat severe cases of dehydration.	2,470	$140	$336.3K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	1,340	$200	$260.5K

Showing 1–10 of 239

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

Shc Medical Center Toppenish — 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

239 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	69	100	2,830	$80	$3.8M
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.	38	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.	67	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.	39	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.	87	190	5,130	$100	$1.8M
G0481	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	30	30	660	$100	$1.5M
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.	64	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.	70	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.	43	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.	48	70	2,010	$210	$620.1K

Showing 1–10 of 239

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
Sunnyside Community Hospital Association	WA	Rural Health Clinic/Center	$0	$7M
Shc Medical Center - Yakima	WA	General Acute Care Hospital	$0	$6.9M
Sunnyside Community Hospital Association	WA	Rural Health Clinic/Center	$0	$5.8M
Shc Medical Center Toppenish	WA	Rural Health Clinic/Center	$0	$5M
Sunnyside Community Hospital Association	WA	Rural Health Clinic/Center	$0	$4.4M
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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Yakima Valley Farm Workers Clinic	WA	Federally Qualified Health Center (FQHC)	$0	$51.9M
Yakama Indian Health Center	WA	Federal Public Health Clinic/Center	$0	$34M
Yakima Valley Farm Workers Clinic	WA	Federally Qualified Health Center (FQHC)	$0	$19.8M
Yakima Valley Farm Workers Clinic	WA	Federally Qualified Health Center (FQHC)	$0	$13.8M
Yakima Valley Farm Workers Clinic	WA	Federally Qualified Health Center (FQHC)	$0	$6.6M
Olney Emergency Group, A Professional LLC	WA	Emergency Medicine Physician	$0	$3.4M
Laboratory Corporation Of America	WA	Clinical Medical Laboratory	$410	$100.5K
Rory Sumners	WA	Family Medicine Physician	$55.6K	$0
Danial Hocson	WA	Family Medicine Physician	$51.7K	$0
Reuben Ramoz	WA	Internal Medicine Physician	$43.1K	$0

Shc Medical Center Toppenish — Billing Profile & Reimbursement Data

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Shc Medical Center Toppenish — 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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