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 Missouri for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Missouri 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. Missouri (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.

Washington University (NPI 1992746903)

Washington University is a multi-specialty clinic/center provider located in Saint Louis, Missouri. This profile covers 0 Medicare and 114 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Washington University
Address	660 S Euclid Ave
City	Saint Louis
State	MO
ZIP	63110
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	June 9, 2006

Payer Source	Total Paid
Medicaid	$14.8M
Medicare	$0

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

114 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…	78,850	$60	$4.3M
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…	58,550	$40	$2.1M
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…	52,090	$30	$1.7M
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	9,290	$130	$1.2M
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…	19,420	$50	$931.9K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	10,700	$70	$716.6K
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…	3,630	$80	$305.1K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	56,350	$10	$281.7K
99255	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a high level of medical decision making or the provider spends at…	3,020	$90	$277.6K
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…	1,860	$130	$234.6K

Showing 1–10 of 114

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

Washington University — 18 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

114 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	33	240	1,740	$40	$353.4K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	25	320	980	$40	$352.7K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	1	40	530	$130	$144.7K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	31	30	90	$340	$140.3K
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	45	120	260	$50	$136.3K
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…	12	3,170	230	$70	$128.1K
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…	5	590	260	$40	$120.5K
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…	17	4,310	300	$60	$110.8K
85027	The lab analyst performs a blood count on the red and white blood cells and platelets also known as thrombocytes. He also determines the hemoglobin, typically by spectrophotometry, and the…	23	120	130	$60	$103K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	2	150	80	$150	$93.6K

Showing 1–10 of 114

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Washington University	MO	Multi-Specialty Clinic/Center	$0	$22M
Washington University	MO	Multi-Specialty Clinic/Center	$0	$10.4M
Southern Illinois Healthcare Foundation, Inc.	IL	Federally Qualified Health Center (FQHC)	$0	$9.8M
Washington University	MO	Emergency Care Clinic/Center	$0	$9.1M
Washington University	MO	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$6.9M
Washington University	MO	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.4M
Washington University	MO	Multi-Specialty Clinic/Center	$0	$4M
John Visconti	IL	Medical Oncology Physician	$2.8M	$149.1K
Peter Oppelt	MO	Medical Oncology Physician	$2.5M	$15.8K
Ronald Dean	MT	Emergency Medicine Physician	$2.3M	$2.3K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Council For Extended Care	MO	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$98.1M
St. Louis Children's Hospital	MO	Children's Hospital	$0	$66.9M
Barnes Jewish Hospital	MO	General Acute Care Hospital	$0	$61.4M
Paraquad Inc	MO	Customized Equipment (DME)	$0	$56.3M
Cooperative Home Care, Inc.	MO	Home Health Agency	$0	$20.6M
New Beginnings In Home Services, LLC	MO	In Home Supportive Care Agency	$0	$11.6M
Bjc Home Care Services	MO	Durable Medical Equipment & Medical Supplies	$0	$8.2M
Wallace Family In Home Health LLC	MO	In Home Supportive Care Agency	$0	$6.6M
Cooperative Home Care	MO	Home Health Agency	$0	$5.5M
Josephines Caring Hands	MO	In Home Supportive Care Agency	$0	$3.4M

Washington University — Billing Profile & Reimbursement Data

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Washington University — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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