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 District of Columbia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to District of Columbia 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. District of Columbia (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 Hospital (NPI 1932190626)

Key Findings

Field	Value
Entity Type	Organization
Organization	Providence Hospital
Address	1150 Varnum St Ne
City	Washington
State	DC
ZIP	20017
Taxonomy	General Acute Care Hospital
NPI Enumerated	November 2, 2005

Payer Source	Total Paid
Medicaid	$12.2M
Medicare	$0

PROVIDENCE HOSPITAL reports no Medicare billing on file and $12.2M in total Medicaid revenue, meaning its reimbursed activity in the dataset is effectively single‑payer Medicaid rather than a mixed Medicare/Medicaid profile. This makes Medicaid the primary lens for assessing both revenue drivers and competitive positioning for the facility.

Revenue is concentrated in a small set of Medicaid codes: the top 3 Medicaid codes by revenue account for 37.6% of this provider's total Medicaid revenue, led by 99284 ($1.5M, 10K claims, 16.1%), 99283 ($1M, 6.5K claims, 10.9%), and 97110 ($1M, 6.2K claims, 10.6%). This concentration indicates that a minority of services are delivering a disproportionate share of the provider’s Medicaid dollars.

The code mix points to a strong emergency department footprint. High-volume ED E/M codes appear throughout the top contributors—99284 (10K claims), 99283 (6.5K claims), 99285 (4.3K claims) and 99282 (3K claims)—which together reflect substantial acute care and ED throughput rather than a purely ambulatory clinic model.

Rehabilitation and therapy services are a meaningful revenue stream alongside ED care: 97110 (therapeutic exercise) accounts for $1M (6.2K claims) and ranks #10 of 27 in-state (65th percentile), and related PT codes such as 97010 ($567.1K, 1.6K claims) and 97014 ($213.4K, 1K claims) further support an active physical‑therapy program. These patterns suggest parallel investment in outpatient rehab capacity that complements the hospital’s acute care case mix.

On competitive standing, the facility is a typical in-state participant for its highest-volume codes rather than a dominant player: 99284 ranks #12 of 34 (67th percentile) and 99283 ranks #14 of 38 (65th percentile), both described as "typical, unremarkable volume for this code." By contrast, the outpatient established-patient code 99214 ranks #73 of 305 (76th percentile), indicating relatively stronger performance in office/outpatient E/M visits compared with many peers statewide.

Specialty procedures and diagnostic studies contribute notable, though smaller, shares of revenue. Cataract surgery 66984 generates $402.8K (551 claims, $731 avg paid/claim) and sleep studies such as 95810 ($185.8K, $678 avg paid/claim) and 95811 ($157K, $657 avg paid/claim) are present, signaling capability in ophthalmology and polysomnography that supplement the hospital’s core ED and rehab services.

Several codes land at the low end of in-state peer distributions despite producing material dollars: 96361 ($382.7K, 952 claims) ranks #8 of 8 (0th percentile), G0378 ($137.1K, 1.4K claims) ranks #8 of 8 (0th percentile), and 94660 ($130.5K) ranks #3 of 3 (0th percentile). These 0th‑percentile placements indicate that for these particular services the hospital is at the lower bound of peer activity in the state even though the services are revenue contributors for the facility.

The provider has a long tenure in the NPI file (enumerated 2005-11-02, ~21 years ago), so current Medicaid-only billing is unlikely to reflect a newly established entity; instead, the profile suggests an established hospital with Medicaid-focused reimbursement in this dataset, which should be interpreted in the context of local payer mix and contracting rather than as a result of short operational history.

Medicaid: Complete Services Breakdown

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

303 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	9,980	$150	$1.5M
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.	6,490	$160	$1M
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…	6,240	$160	$1M
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.	4,270	$150	$623.7K
97010	The provider, such as physical therapist, applies a hot or cold pack to a specific body site to treat an injury or disease.	1,600	$350	$567.1K
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…	3,420	$120	$413.5K
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.	2,970	$140	$403.5K
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	550	$730	$402.8K
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.	950	$400	$382.7K
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…	2,890	$120	$352K

Showing 1–10 of 303

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other District of Columbia providers billing the same CPT/HCPCS codes.

Claims Volume vs. District of Columbia Distribution

Providence Hospital — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — District of Columbia

Full comparison — all codes billed, vs. District of Columbia median

303 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	8	10	5,630	$540	$4.4M
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.	14	30	4,480	$140	$3.5M
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.	12	30	540	$140	$3.4M
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.	14	40	190	$150	$3.3M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	5	10	6,080	$100	$2M
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.	10	10	5,170	$170	$1.9M
99281	The provider sees a patient for the lowest level emergency department visit.	8	10	1,890	$220	$1.6M
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	30	3,790	$110	$1.4M
G0378	Hospital observation service, per hour	8	10	7,540	$130	$1.3M
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.	13	30	1,320	$110	$1M

Showing 1–10 of 303

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Providence Health Services Inc	DC	Family Medicine Physician	$0	$13.4M
Alabama Providence Healthcare Services	AL	Internal Medicine Physician	$0	$4.7M
Farida Awan	AL	Pediatrics Physician	$0	$2.3M
John Ledoux	AL	Interventional Cardiology Physician	$648.8K	$0
Farzad Davoudian	VA	Psychiatry Physician	$73.1K	$401.1K
Felicie Wyatt	MS	Internal Medicine Physician	$376.9K	$0
Philip Proctor	MD	Urology Physician	$346.6K	$0
Muhammad Shibli	DC	Pulmonary Disease Physician	$320.3K	$0
Joseph Oppong	MD	Interventional Pain Medicine Physician	$300.3K	$0
Javier Quant-gonzalez	MD	Internal Medicine Physician	$298.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
My Own Place, Inc.	DC	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$48.7M
Anchor Mental Health Association	DC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$22M
Hsc Home Care, LLC	DC	Home Health Agency	$0	$14.7M
American Health Care Services Inc	DC	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$5.3M
Hospital For Sick Children	DC	Special Hospital	$0	$4.7M
United Cerebral Palsy Of Washington & No. Virginia, Inc.	DC	Developmentally Disabled Services Day Training Agency	$0	$4.4M
Gerald Family Care	DC	Family Medicine Physician	$0	$3.2M
Cheryl Lee	DC	Dentist	$0	$2.5M
Providence Opticians Designer Eyewear Inc	DC	Eyewear Supplier	$0	$2.1M
On With Life Therapies, Inc	DC	Home Health Agency	$0	$1.8M

Providence Hospital — Billing Profile & Reimbursement Data

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Providence Hospital — 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