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.

Swofford & Halma Clinic, Inc. P.s. (NPI 1992758486)

Swofford & Halma Clinic, Inc. P.s. is a family medicine physician provider located in Sunnyside, Washington. This profile covers 0 Medicare and 90 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	Swofford & Halma Clinic, Inc. P.s.
Address	2303 Reith Way
City	Sunnyside
State	WA
ZIP	98944
Taxonomy	Family Medicine Physician
NPI Enumerated	May 18, 2006

Payer Source	Total Paid
Medicaid	$5.4M
Medicare	$0

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

90 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	52,800	$60	$3.1M
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…	6,570	$70	$453K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	3,980	$90	$342.4K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	3,410	$90	$320.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2,590	$90	$243.6K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1,780	$100	$183.3K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	3,570	$40	$128.3K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	5,080	$20	$76.1K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	3,440	$20	$51.5K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	650	$70	$41.9K

Showing 1–10 of 90

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

Swofford & Halma Clinic, Inc. P.s. — 1 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

90 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	514	650	4,110	$250	$4.9M
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…	265	1,820	480	$60	$379.6K
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…	56	1,860	610	$40	$295.5K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	47	280	540	$70	$166.5K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	54	300	400	$80	$164.4K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	53	100	820	$60	$147.7K
D0120	Periodic oral evaluation - established patient	627	920	690	$20	$131.3K
76856	A pelvic ultrasound is a noninvasive procedure used to assess body parts such as the bladder, ovaries, uterus, cervix, and fallopian tubes in females and the bladder, prostate gland, and seminal…	119	120	1,200	$60	$124.4K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	117	210	690	$40	$114.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	52	320	290	$70	$104.8K

Showing 1–10 of 90

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sunnyside Community Hospital Association	WA	Critical Access Hospital	$0	$55.1M
Thompson Dmd PLLC	WA	Dentist	$0	$36.6M
Sunnyside Community Hospital Association	WA	Rural Health Clinic/Center	$0	$7M
Total Renal Care Inc	WA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$6.1M
Sunnyside Community Hospital Association	WA	Rural Health Clinic/Center	$0	$5.8M
Sunnyside Community Hospital Association	WA	Rural Health Clinic/Center	$0	$4.4M
Mid-valley Community Clinic, PLLC	WA	Family Medicine Physician	$0	$4.4M
Thompson.ferguson.steinhart.james.leavitt,pllc	WA	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$4.2M
Sunnyside Emergency Group A Professional LLC	WA	Emergency Medicine Physician	$0	$3.8M
Derek S Weaver Do PLLC	WA	Family Medicine Physician	$0	$2.6M

Swofford & Halma Clinic, Inc. P.s. — 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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