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.

Franciscan Health System (NPI 1952309098)

Key Findings

Field	Value
Entity Type	Organization
Organization	Franciscan Health System
Address	1717 S J St
City	Tacoma
State	WA
ZIP	98405
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 12, 2005

Payer Source	Total Paid
Medicaid	$44.6M
Medicare	$0

Franciscan Health System appears to operate primarily as a Medicaid-serving general acute care hospital in Tacoma, WA, with $44.6M in lifetime Medicaid revenue and no Medicare billing on file; this makes the organization effectively single-payer in our dataset and suggests its observable billing footprint is concentrated in Medicaid-funded services. The NPI was enumerated on 2005-07-12 (~21 years ago), indicating a long-established facility with two decades of billing history to support its current service mix and volume.

Revenue concentration is meaningfully skewed toward a small set of high-volume Medicaid codes: the precomputed top 3 Medicaid codes by revenue account for 31.2% of total Medicaid revenue, indicating the provider relies on a limited number of service lines for nearly one-third of Medicaid revenue. Among individual codes, 96361 alone generates $4.8M (14.0% of Medicaid revenue), making IV fluids/maintenance infusions a leading revenue driver in the outpatient/inpatient infusion space.

The code mix shows a strong emergency and acute care orientation: ED evaluation and management codes 99284, 99283, 99285, and 99282 collectively appear among the top revenue codes (each contributing multiple-percent shares), which aligns with a high-volume emergency department treating a broad triage range from straightforward to high-complexity cases. G0463 and G0382/G0383 further confirm frequent hospital outpatient and ED-type encounters, consistent with a large acute-care hospital handling urgent and emergent presentations.

Procedural and ancillary service lines also contribute materially: high-volume infusion and infusion-related codes (96361, 96365, 96366, 96360) plus imaging and interventional codes (70450, 74177, 93458, 71275) and diagnostic procedures (43239) indicate the facility performs a mix of therapeutic infusions, CT imaging, cardiac catheterization imaging supervision, and endoscopy, supporting a full-service hospital profile. Physical and rehabilitative therapy codes (97110, 97530, 97140) are notable for volume as well, suggesting integrated therapy services for inpatient or outpatient recovery populations.

Competitive standing within Washington Medicaid is mixed by code: the provider ranks in the top percentiles for many high-volume therapy and wound-care codes—97110 ranks #4 of 476 providers (99th percentile) and 11042 ranks #3 of 79 providers (97th percentile), with 11045 at #1 of 14 providers (100th percentile) noted as an extreme outlier—indicating regional leadership in therapeutic exercise and debridement services. By contrast, several high-revenue ED and imaging codes are described as typical or unremarkable volumes (percentiles in the 70s–80s), implying strong absolute volumes but not exclusive market dominance across those categories.

Several codes are flagged as statistically notable: 11042 is an “extreme outlier, far above typical state volume,” and 11045 is at the 100th percentile for the state—these wound debridement codes indicate an outsized regional concentration of complex wound care procedures relative to in-state peers. Other service areas with ‘‘notably above typical’’ volume include 97110, 97530, 78452, 93458, and 97140, pointing to particularly high regional market share in physical therapy, nuclear cardiology, and cardiac imaging interpretation.

The provider’s lack of Medicare billing on file is important context for payer mix and contracting: because Medicare revenue is recorded as none while Medicaid equals $44.6M, analyses of payer risk, case mix index, and commercial contracting should treat this entity as observable only through its Medicaid activity in our data, and any conclusions about Medicare-facing capacity cannot be drawn from these records. This single-payer visibility also concentrates analytic risk on Medicaid claims for assessing utilization and capacity.

Medicaid: Complete Services Breakdown

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

394 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	17,330	$280	$4.8M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	42,590	$70	$3M
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.	40,610	$70	$3M
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.	33,370	$90	$2.9M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	34,500	$70	$2.6M
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	19,740	$120	$2.4M
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.	26,750	$80	$2.1M
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…	65,910	$20	$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.	8,970	$140	$1.2M
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.	10,490	$120	$1.2M

Showing 1–10 of 394

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

Franciscan Health System — 7 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

394 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	26	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.	21	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.	35	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.	43	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.	41	190	5,130	$100	$1.8M
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.	34	140	2,830	$150	$1.1M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	8	100	1,940	$70	$1M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	20	20	190	$1,670	$956.2K
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.	23	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.	23	100	3,660	$100	$635.7K

Showing 1–10 of 394

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Franciscan Medical Group	WA	Family Medicine Physician	$0	$92.6M
Franciscan Medical Group	WA	Internal Medicine Physician	$0	$7.7M
Franciscan Health System	WA	Internal Medicine Physician	$0	$6.4M
Franciscan Health System	WA	Durable Medical Equipment & Medical Supplies	$0	$2.7M
Daniel Gottlieb	WA	Cardiovascular Disease Physician	$204K	$13.3K
Ming Zhang	WA	Interventional Cardiology Physician	$165.8K	$0
Nagavedu Raghunath	WA	Psychiatry Physician	$116.7K	$0
Daniel Heller	WA	Diagnostic Radiology Physician	$113.5K	$0
Howard Sun	WA	Vascular & Interventional Radiology Physician	$84.2K	$0
Mark Yuhasz	WA	Diagnostic Radiology Physician	$73.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Multicare Health System	WA	General Acute Care Hospital	$0	$162.2M
Multicare Health System	WA	Children's Hospital	$0	$108.4M
Multicare Health System	WA	Family Medicine Physician	$0	$75M
Multicare Health System	WA	Pediatrics Physician	$0	$29.4M
Western Psychological And Counseling Services LLC	WA	Clinical Psychologist	$0	$20.8M
Sound Health Medical Supply	WA	Customized Equipment (DME)	$0	$20.7M
Tra-minw P S	WA	Radiology Clinic/Center	$0	$14.5M
Advanced Lifeline Services	WA	SNF/Subacute Care Certified Respiratory Therapist	$0	$12.5M
Tacoma Emergency Care Physicians, PLLC	WA	Emergency Medicine Physician	$0	$12.1M
Multicare Health System	WA	Home Infusion Therapy Pharmacy	$0	$11.2M

Franciscan Health System — 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