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.

Kadlec Regional Medical Center (NPI 1972507580)

Field	Value
Entity Type	Organization
Organization	Kadlec Regional Medical Center
Address	888 Swift Blvd
City	Richland
State	WA
ZIP	99352
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 10, 2005

Payer Source	Total Paid
Medicaid	$151.5M
Medicare	$0

Key Findings

KADLEC REGIONAL MEDICAL CENTER reports $151.5M in lifetime Medicaid revenue and has no Medicare billing on file, making its public billing footprint effectively single-payer Medicaid. Its NPI was enumerated on 2005-06-10 (~21 years ago), indicating two decades of presence in the data without recorded Medicare activity.

Revenue is highly concentrated: the precomputed top 3 Medicaid codes account for 51.9% of the provider's total Medicaid revenue, with G0463 contributing $31.7M (28.6%), 99283 contributing $14M (12.7%), and 99214 contributing $11.8M (10.6%). This concentration shows a small set of service lines driving the majority of Medicaid payments.

The code mix indicates the hospital operates a large outpatient and emergency care platform: G0463 has 377.1K claims and is described as a hospital outpatient clinic visit, 99283 has 117.7K claims and is an ED E/M code, and 99214 has 240.2K claims as an established outpatient visit. Together these volumes point to high-throughput ambulatory and ED workflows rather than a revenue base concentrated in complex tertiary-only procedures.

Emergency department services are a clear operational focus. 99283 ranks #5 of 234 providers in-state (98th percentile; extreme outlier) with $14M revenue, and additional ED codes (99284, 99285, 99282, 99281) appear high in state percentiles—99281 is #2 of 76 (99th percentile; extreme outlier)—indicating ED visits are both numerous and above-typical compared with peers.

Ambulatory primary and preventive care volume is also elevated: 99214 has 240.2K claims and ranks #9 of 1823 providers in-state (100th percentile; extreme outlier) while preventive codes such as 99392 (20.6K claims, $1.6M) rank #3 of 299 (99th percentile; extreme outlier). These placements signal the provider captures substantial outpatient follow-up and wellness visit volume within the state.

The facility also delivers infusion, oncology, imaging, and surgical services that materially contribute to Medicaid revenue. Notable examples include 96361 (26.3K claims, $8M revenue), J9271 (695 claims, $2.8M revenue) for pembrolizumab, 74177 (13.2K claims, $2.3M), and 44970 (381 claims, $1.2M), showing a mixed case-mix beyond routine E/M visits. Some infusion and imaging codes rank in mid-to-high percentiles (e.g., 96361 at the 90th percentile), indicating these are established service lines but not uniformly extreme outliers.

Competitive standing in-state is strong for multiple high-volume codes: G0463 is #5 of 103 (96th percentile; extreme outlier), 99283 is #5 of 234 (98th percentile; extreme outlier), and 99214 is #9 of 1823 (100th percentile; extreme outlier). Beyond the top three, a number of additional codes (e.g., 99213, 99392, 97110, 97530) sit in the 97th–99th percentiles, demonstrating a broad high-volume footprint relative to in-state peers.

The combination of a single dominant payer (Medicaid), high concentration in three codes (51.9% of Medicaid revenue), and large absolute claim volumes suggests both operational leverage and vulnerability: changes in Medicaid policy, reimbursement for G0463/ED E/M services, or volume shifts could materially affect revenue. Conversely, the breadth of elevated service lines—ED, outpatient, infusion, imaging, and surgery—also provides diversification inside the Medicaid payer stream that can be targeted for payer contracting or care-delivery optimization.

Medicaid: Complete Services Breakdown

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

703 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	377,050	$80	$31.7M
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.	117,680	$120	$14M
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…	240,160	$50	$11.8M
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…	193,320	$40	$8.1M
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.	26,320	$300	$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.	69,190	$90	$6.4M
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.	41,660	$90	$3.6M
J9271	Injection, pembrolizumab, 1 mg	700	$4,090	$2.8M
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.	13,240	$170	$2.3M
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.	21,020	$90	$1.9M

Showing 1–10 of 703

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

Kadlec Regional Medical Center — 12 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

703 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	5	100	2,830	$80	$3.8M
J9271	Injection, pembrolizumab, 1 mg	5	10	270	$3,820	$2.9M
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.	11	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.	15	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.	5	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.	26	190	5,130	$100	$1.8M
J2323	Injection, natalizumab, 1 mg	5	10	1,110	$1,460	$1.5M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	2	10	730	$270	$1.2M
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.	16	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…	20	100	1,940	$70	$1M

Showing 1–10 of 703

Related Providers

Other providers that share a Tax Identification Number (TIN) with Kadlec Regional Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Health First Urgent Care, PLLC	WA	Urgent Care Clinic/Center	$0	$5.2M
Guy Jones	NV	Radiation Oncology Physician	$2.5M	$0
Amr El-sergany	HI	Vascular Surgery Physician	$1.5M	$0
Kadlec Regional Medical Center	WA	Ambulatory Surgical Clinic/Center	$571.3K	$815.5K
Sherry Zhao	WA	Radiation Oncology Physician	$1.3M	$0
Kadlec Regional Medical Center	WA	Ambulatory Surgical Clinic/Center	$231.7K	$158.7K
Glen Zuroske	WA	Cardiovascular Disease Physician	$372.5K	$0
Fareed Arif	WA	Nephrology Physician	$369.2K	$0
Melvin Wahl	WA	Orthopaedic Surgery of the Spine Physician	$327.4K	$0
Sarena Sloot	WA	Nurse Practitioner	$307.9K	$0

Nearby Providers

Other providers in the same ZIP code as Kadlec Regional Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gill, Ritchie, Walker PLLC	WA	Ambulatory Surgical Clinic/Center	$0	$10.7M
City Of Richland	WA	Ambulance	$679.8K	$7.8M
Ortc, LLC	WA	Methadone Clinic	$0	$6.2M
American Medical Response Ambulance Service Inc	WA	Ambulance	$1.1M	$3M
Total Renal Care Inc	WA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3.8M
Tri-city Orthodontics, LLC	WA	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$2.9M
Alexey Ryskin	WA	Pain Medicine (Anesthesiology) Physician	$2.3M	$990
Sidney Smith	WA	Dermatology Physician	$2.1M	$0
Cheryl Lee	WA	Ophthalmology Physician	$1.5M	$0
Saravanan Kasthuri	WA	Vascular & Interventional Radiology Physician	$1.1M	$0

Kadlec Regional Medical Center — 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