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.

Stanford Health Care (NPI 1871543215)

Field	Value
Entity Type	Organization
Organization	Stanford Health Care
Address	300 Pasteur Dr
City	Stanford
State	CA
ZIP	94305
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 10, 2006

Payer Source	Total Paid
Medicaid	$264.9M
Medicare	$0

Key Findings

STANFORD HEALTH CARE shows no Medicare billing on file and reports $264.9M in lifetime Medicaid revenue, making its publicly visible payer footprint effectively concentrated in Medicaid rather than a dual Medicare/Medicaid mix. The absence of Medicare billing suggests payer dependence and strategic exposure to Medicaid policy and reimbursement changes, rather than balanced risk across the two dominant public payers.

Revenue is notably concentrated in a small set of high-value codes: the precomputed top three Medicaid codes account for 30.9% of the provider's total Medicaid revenue, led by J9271 (1.9K claims, $13254 avg paid/claim, $24.5M revenue; 17.2%). The two other top contributors are 0450 (125.7K claims, $90 avg paid/claim, $11.3M revenue; 7.9%) and 0510 (226.9K claims, $36 avg paid/claim, $8.2M revenue; 5.7%), highlighting a concentrated revenue base where a small set of codes drives nearly a third of Medicaid receipts.

The code mix and descriptions point strongly to a high-volume oncology and advanced-imaging service line: high-revenue oncology agents and supportive drugs appear throughout the top codes (for example, J9271 pembrolizumab $24.5M, J9035 bevacizumab $7M, J9299 nivolumab $5.2M, J9355 trastuzumab $4M, J2505/J2506 pegfilgrastim $5M/$2.9M). Complementary high-cost imaging and radiation codes such as 78815 (5.5K claims, $1372 avg, $7.5M), 70553 (9K claims, $766 avg, $6.9M) and 77386 (12.5K claims, $497 avg, $6.2M) further support a clinical profile centered on oncology diagnostics and complex therapeutic delivery.

Statewide competitive standing is strong in several specialty and volume-driven areas: STANFORD ranks at or near the top for telehealth originating site (Q3014: 175K claims, $20 avg, $3.5M revenue; ranks #1 of 341 providers in-state, 100th percentile; extreme outlier) and posts top-tier ranks for several imaging and oncology-related codes (e.g., 0510 rank #6 of 227, 98th percentile; 70553 rank #7 of 332, 98th percentile; 78815 rank #7 of 229, 97th percentile). These placements indicate the provider is a major statewide hub for telehealth, advanced imaging, and oncology services rather than a marginal participant.

Several individual codes are flagged as statistical outliers or notably above typical state volume, underscoring concentrated operational niches: 0510 is listed as an "extreme outlier, far above typical state volume for this code," Q3014 is an "extreme outlier, far above typical state volume for this code," and 70553 and 78815 are "notably above typical state volume." At the same time, some high-revenue oncology products (J9271) are characterized as "typical, unremarkable volume," indicating a mix of dominant and routine patterns across different therapeutic lines.

Operational scale is evident from very large claim counts across routine and advanced services: examples include 80053 (219.6K claims, $21 avg paid/claim, $4.6M revenue, 99th percentile) and Q3014 telehealth claims (175K). Those volumes, together with the $264.9M Medicaid revenue total, reflect a large, established hospital-level operation that delivers both high-throughput lab/telehealth services and high-acuity specialty care.

Emergency and acute evaluation-and-management activity supports a substantial ED throughput but is not uniformly top-ranked statewide: 99284 (10.5K claims, $522 avg, $5.5M revenue; ranks #283 of 1395, 80th percentile), 99283 (7.2K claims, $437 avg, $3.1M revenue) and 99281 (8.3K claims, $325 avg, $2.7M revenue) together show material ED volume consistent with a major acute-care provider, while their percentile placements indicate the ED is busy but not the single statewide leader.

The provider has a long operational tenure with its NPI enumerated on 2006-05-10 (~20 years ago), which, combined with high Medicaid revenues and numerous top-percentile ranks in imaging, oncology, and telehealth, suggests an established, large-scale clinical operation with concentrated strengths in cancer care delivery and remote-originating-site telehealth services.

Medicaid: Complete Services Breakdown

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

782 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	1,850	$13,250	$24.5M
0450	N/A	125,650	$90	$11.3M
0510	N/A	226,870	$40	$8.2M
78815	PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.…	5,500	$1,370	$7.5M
J9035	Injection, bevacizumab, 10 mg	3,420	$2,050	$7M
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	9,050	$770	$6.9M
77386	Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex	12,480	$500	$6.2M
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.	21,790	$270	$5.8M
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.	10,540	$520	$5.5M
J9299	Injection, nivolumab, 1 mg	800	$6,490	$5.2M

Showing 1–10 of 782

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

Stanford Health Care — 11 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

782 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90999	Use 90999 to report dialysis services or procedures that do not have a specific code.	729	730	25,970	$150	$4.5M
0450	N/A	38	450	16,140	$90	$3.6M
J9271	Injection, pembrolizumab, 1 mg	6	60	240	$4,460	$3.4M
J9299	Injection, nivolumab, 1 mg	11	20	810	$3,160	$3.1M
0121	N/A	64	70	130	$4,600	$2.6M
0681	N/A	3	10	40	$7,220	$2.4M
77386	Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex	3	20	880	$600	$2.4M
J2350	Injection, ocrelizumab, 1 mg	1	10	30	$25,040	$1.7M
J9144	Injection, daratumumab, 10 mg and hyaluronidase‑fihj	6	10	220	$4,600	$1.5M
J2323	Injection, natalizumab, 1 mg	2	10	270	$1,930	$1.5M

Showing 1–10 of 782

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Stanford Health Care	CA	General Acute Care Hospital	$0	$46.2M
Ira Schachar	CA	Retina Specialist (Ophthalmology) Physician	$3.9M	$4.1M
Khosrow Mehrany	CA	Specialist	$7.7M	$0
Roger Goldberg	CA	Retina Specialist (Ophthalmology) Physician	$4.6M	$0
Clement Chow	CA	Ophthalmology Physician	$3.8M	$0
Christianne Wa	CA	Retina Specialist (Ophthalmology) Physician	$3.5M	$0
Howard Chen	CA	Ophthalmology Physician	$2.8M	$0
Tushar Ranchod	CA	Retina Specialist (Ophthalmology) Physician	$2.6M	$0
Tuow Ting	CA	Retina Specialist (Ophthalmology) Physician	$2.6M	$0
J Jumper	CA	Retina Specialist (Ophthalmology) Physician	$2.6M	$0

Nearby Providers

Other providers in the same ZIP code as Stanford Health Care, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ehsan Rahimy	CA	Retina Specialist (Ophthalmology) Physician	$1.8M	$0
Stanford Life Flight	CA	Air Ambulance	$464.2K	$1.2M
Kim-son Nguyen	CA	Medical Oncology Physician	$1.5M	$0
Chivonne Harrigal	CA	Diagnostic Radiology Physician	$1.3M	$1.1K
Nadim Rayess	CA	Ophthalmology Physician	$1.2M	$0
Howard Harvin	CA	Body Imaging Physician	$684.8K	$0
Robert Mayle	CA	Orthopaedic Surgery Physician	$573.7K	$0
Cheena Ramrakhiani	CA	Cardiovascular Disease Physician	$498.7K	$0
John Kleimeyer	CA	Orthopaedic Surgery of the Spine Physician	$383.8K	$0
Todd Alamin	CA	Orthopaedic Surgery of the Spine Physician	$327K	$0

Stanford Health Care — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References