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.

Shriners Hospitals For Children (NPI 1992848857)

Shriners Hospitals For Children is a children's hospital provider located in Spokane, Washington. This profile covers 0 Medicare and 58 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	Shriners Hospitals For Children
Address	911 W 5th Ave
City	Spokane
State	WA
ZIP	99204
Taxonomy	Children's Hospital
NPI Enumerated	February 14, 2007

Payer Source	Total Paid
Medicaid	$6.1M
Medicare	$0

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

58 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	35,210	$130	$4.6M
25600	The provider treats a fracture of the wrist end of the radius, one of the bones in the forearm, in which the fracture fragment displaces upward or downward, in a closed procedure. The growth plate at…	910	$440	$397.2K
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…	7,760	$50	$372.6K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	2,840	$70	$201.6K
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	2,320	$60	$132.4K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	1,460	$70	$108.3K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	1,650	$40	$64.4K
29075	The provider applies a cast encasing the lower arm. A short arm cast treats fractures of the bones in the lower arm and corrects deformities of the hand and wrist.	120	$260	$30.6K
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…	540	$50	$26K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	150	$170	$25.2K

Showing 1–10 of 58

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

Shriners Hospitals For Children — 5 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

58 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	25	100	2,830	$80	$3.8M
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…	1,722	1,860	610	$40	$295.5K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	163	280	1,920	$40	$262.1K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	198	590	1,280	$50	$244.5K
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.	206	240	2,430	$10	$194.2K
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…	96	480	1,160	$30	$180.9K
29075	The provider applies a cast encasing the lower arm. A short arm cast treats fractures of the bones in the lower arm and corrects deformities of the hand and wrist.	7	10	120	$280	$129.5K
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…	112	210	690	$40	$114.5K
25600	The provider treats a fracture of the wrist end of the radius, one of the bones in the forearm, in which the fracture fragment displaces upward or downward, in a closed procedure. The growth plate at…	1	10	30	$430	$104.9K
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…	226	270	2,880	$1	$100.6K

Showing 1–10 of 58

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shriners Hospitals For Children	SC	Children's Hospital	$0	$4.3M
Shriners Hospitals For Children	OR	Children's Hospital	$0	$3.9M
Shriners Hospitals For Children	HI	Children's Hospital	$0	$2.8M
Peggy Liao	HI	Ophthalmology Physician	$3.3K	$968K
John Vanaalst	KY	Plastic and Reconstructive Surgery Physician	$672K	$0
Shriners Hospitals For Children	UT	Children's Hospital	$0	$605.5K
Ryan Nunley	MO	Adult Reconstructive Orthopaedic Surgery Physician	$469.2K	$0
Robert Tychsen	MO	Ophthalmology Physician	$8.6K	$455.1K
Steven Wilhelm	WA	Diagnostic Radiology Physician	$439.1K	$0
Mohammadali Mojarrad	MA	Diagnostic Radiology Physician	$343.4K	$40.3K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Providence Health & Services - Wa	WA	General Acute Care Hospital	$0	$78.7M
Providence Health & Services Washington	WA	Pulmonary Disease Physician	$0	$78.6M
Multicare Health System	WA	General Acute Care Hospital	$0	$55.1M
New Horizon Care Center, Inc.	WA	Substance Abuse Rehabilitation Facility	$0	$20.2M
Spokane Addiction Recovery Centers	WA	Substance Abuse Rehabilitation Facility	$0	$19M
Spokane Emergency Care Physicians PLLC	WA	Emergency Medicine Physician	$0	$13.9M
Spokane Emergency Physicians, Ps	WA	Emergency Medicine Physician	$0	$13.1M
Providence Health & Services Washington	WA	Clinical Medical Laboratory	$1.6M	$9.3M
Spokane Eye Clinic Ps	WA	Multi-Specialty Clinic/Center	$0	$8M
Laboratory Corporation Of America	WA	Clinical Medical Laboratory	$1.6M	$6.1M

Shriners Hospitals For Children — 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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