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.

Providence Health & Services - Washington (NPI 1922259738)

Field	Value
Entity Type	Organization
Organization	Providence Health & Services - Washington
Address	380 Chase Avenue
City	Walla Walla
State	WA
ZIP	99362
Taxonomy	Family Medicine Physician
NPI Enumerated	October 10, 2008

Payer Source	Total Paid
Medicaid	$7.6M
Medicare	$0

Medicaid: Complete Services Breakdown

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

111 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…	51,610	$50	$2.8M
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…	45,960	$40	$2M
J0585	Injection, onabotulinumtoxina, 1 unit	510	$580	$293.6K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	5,880	$50	$270.4K
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…	10,960	$20	$262.9K
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…	2,560	$90	$225.4K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	3,880	$40	$163K
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…	1,990	$70	$137.4K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	1,880	$70	$125.8K
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…	2,090	$60	$125.1K

Showing 1–10 of 111

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

Providence Health & Services - Washington — 2 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

111 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	182	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.	185	230	6,220	$100	$1.8M
J0585	Injection, onabotulinumtoxina, 1 unit	23	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…	37	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…	40	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.	56	120	590	$230	$331.2K
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…	67	1,860	610	$40	$295.5K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	33	60	240	$380	$276.1K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	33	170	580	$30	$270.4K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	54	140	490	$40	$268.5K

Showing 1–10 of 111

Related Providers

Other providers that share a Tax Identification Number (TIN) with Providence Health & Services - Washington, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Providence Health & Services-wa	WA	General Acute Care Hospital	$0	$62.4M
Georgetown Memorial Hospital	SC	General Acute Care Hospital	$0	$27.6M
Providence Health & Services - Washington	WA	Critical Access Hospital	$0	$26.8M
Providence Health & Services - Washington	WA	General Acute Care Hospital	$0	$17.3M
Providence Health & Services- Washington	WA	General Practice Physician	$0	$7.6M
Providence Health & Services - Washington	WA	Pediatrics Physician	$0	$6.8M
Providence Health & Services - Washington	WA	General Practice Physician	$0	$6M
Providence Health & Services - Washington	WA	Emergency Medicine Physician	$0	$4.3M
Providence Health & Services-washington	WA	Pediatrics Physician	$0	$3.2M
Providence Health & Services - Washington	WA	Family Medicine Physician	$0	$2.9M

Nearby Providers

Other providers in the same ZIP code as Providence Health & Services - Washington, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Privia Medical Group Washington, PLLC	WA	Rural Health Clinic/Center	$0	$19M
Yakima Valley Farm Workers Clinic	WA	Federally Qualified Health Center (FQHC)	$0	$9.3M
Jonathan Gantz	WA	General Practice Dentistry	$0	$4.7M
City Of Walla Walla	WA	Land Ambulance	$527.2K	$4.1M
Yakima Valley Farm Workers Clinic	WA	Federally Qualified Health Center (FQHC)	$0	$3.7M
Privia Medical Group Washington, PLLC	WA	Clinic/Center	$0	$2.8M
Norco, Inc	WA	Durable Medical Equipment & Medical Supplies	$0	$2.5M
David Panther	WA	Dermatology Physician	$762.5K	$0
Andrew Edwards	WA	Ophthalmology Physician	$698.5K	$0
Walla Walla Clinic, Inc.	WA	Ambulatory Surgical Clinic/Center	$414.6K	$0

Providence Health & Services - Washington — Billing Profile & Reimbursement Data

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Providence Health & Services - Washington — 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