Behavioral
Providence Health & Services- Washington
Providence Health & Services- Washington was paid $7.67M by Medicaid between Jan 2018 and Dec 2024, across 124 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 21% of everything it billed.
33Billing provider infoPROVIDENCE HEALTH & SERVICES- WASHINGTON
EVERETT, WA 98201
EVERETT, WA 98201
33aNPI1124270715assigned 10/15/2008
33bProvider typeClinical Social Worker
28Total paid$7.67M
24GClaims203,074
24DCodes billed124
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Clinical Social Worker providers in Washington
Rank by total paid#3 of 86
Median peer was paid$55K
This provider vs. median140×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official ANDERSON, DONALD controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 24,466 | $935K | |
| 2019 | 22,946 | $834K | |
| 2020 | 24,271 | $872K | |
| 2021 | 28,267 | $1.08M | |
| 2022 | 30,550 | $1.39M | |
| 2023 | 38,089 | $1.40M | |
| 2024incomplete | 34,485 | $1.16M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 21% | 28,541 | 27,276 | $1.61M |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 17% | 42,470 | 18,238 | $1.33M |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 12% | 19,036 | 9,414 | $894K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 8.7% | 15,344 | 14,594 | $665K |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 4.8% | 3,830 | 2,850 | $365K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 4.3% | 3,846 | 3,807 | $328K |
| 99223 | Prolong inpt eval add15 m | 4.2% | 3,623 | 3,437 | $324K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.5% | 3,282 | 3,226 | $193K |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | 2.3% | 1,582 | 1,562 | $174K |
| 31231 | 2.1% | 1,521 | 1,489 | $161K | |
| 99205 | Prolong outpt/office vis | 1.6% | 787 | 785 | $124K |
| 90792 | Psychiatric diagnostic evaluation with medical services | 1.6% | 1,209 | 1,190 | $123K |
112 more codes
| 59025 | Fetal non-stress test | 1.5% | 4,144 | $114K |
| 99215 | Doctor's office visit, returning patient (complex) | 1.3% | 1,125 | $100K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 1.2% | 1,607 | $93K |
| 90834 | Psychotherapy session, about 45 minutes | 1.0% | 1,441 | $78K |
| 99220 | 1.0% | 985 | $77K | |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | <1% | 3,089 | $62K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | <1% | 3,293 | $62K |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | <1% | 1,675 | $60K |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 1,039 | $53K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 465 | $44K |
| 92557 | <1% | 2,147 | $43K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 383 | $34K |
| 99217 | <1% | 1,068 | $33K | |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 502 | $31K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 1,447 | $28K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 242 | $28K |
| 90686 | <1% | 1,516 | $27K | |
| 92504 | <1% | 1,617 | $26K | |
| 31575 | <1% | 387 | $23K | |
| 97112 | Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination | <1% | 977 | $22K |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 418 | $22K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 1,690 | $20K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 2,206 | $19K |
| 99310 | Prolong nursin fac eval 15m | <1% | 253 | $17K |
| 69210 | <1% | 764 | $17K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 2,443 | $17K |
| 92567 | <1% | 1,683 | $15K | |
| 96127 | <1% | 2,121 | $14K | |
| 95251 | <1% | 923 | $13K | |
| G2212 | Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes) | <1% | 503 | $12K |
| 99442 | <1% | 256 | $12K | |
| 97161 | <1% | 257 | $12K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 148 | $12K |
| 87800 | <1% | 272 | $11K | |
| 92507 | Treatment of speech, language, voice, communication, and/or auditory processing disorder | <1% | 230 | $11K |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 83 | $10K |
| 51798 | <1% | 1,615 | $7K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 81 | $7K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 2,089 | $7K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 132 | $6K |
| 36415 | Collection of venous blood by venipuncture | <1% | 2,300 | $6K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 123 | $5K |
| 76830 | Ultrasound, transvaginal | <1% | 81 | $4K |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 457 | $4K |
| 95886 | <1% | 44 | $4K | |
| 78452 | Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress | <1% | 37 | $4K |
| 99226 | <1% | 88 | $4K | |
| 97113 | <1% | 119 | $4K | |
| 90670 | <1% | 327 | $3K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 75 | $3K |
| 73562 | <1% | 196 | $3K | |
| 81003 | <1% | 2,083 | $3K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 95 | $3K |
| 99443 | <1% | 25 | $2K | |
| 72100 | <1% | 113 | $2K | |
| 90656 | <1% | 77 | $2K | |
| G0101 | Cervical or vaginal cancer screening; pelvic and clinical breast examination | <1% | 68 | $1K |
| 76942 | <1% | 47 | $1K | |
| 90853 | Group psychotherapy (other than of a multiple-family group) | <1% | 78 | $1K |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | <1% | 28 | $1K |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | <1% | 24 | $1K |
| 95250 | <1% | 14 | $1K | |
| 73030 | <1% | 85 | $1K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 110 | $974.37 |
| 90685 | <1% | 82 | $966.81 | |
| 11104 | <1% | 12 | $947.74 | |
| 52000 | <1% | 12 | $944.90 | |
| 90715 | <1% | 29 | $903.16 | |
| 73630 | <1% | 53 | $797.88 | |
| 99219 | <1% | 12 | $777.48 | |
| 82962 | <1% | 357 | $770.19 | |
| 99242 | <1% | 14 | $743.65 | |
| 81025 | <1% | 98 | $734.07 | |
| 20611 | <1% | 15 | $692.45 | |
| 73610 | <1% | 42 | $691.34 | |
| 99221 | <1% | 12 | $633.90 | |
| 73110 | <1% | 30 | $606.66 | |
| 97150 | Therapeutic procedure(s), group (2 or more individuals) | <1% | 99 | $566.47 |
| 90680 | <1% | 56 | $553.64 | |
| 90633 | <1% | 62 | $530.31 | |
| 90648 | <1% | 43 | $451.64 | |
| 93296 | <1% | 51 | $426.75 | |
| 36416 | <1% | 328 | $408.10 | |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 107 | $404.99 |
| 93000 | <1% | 43 | $372.52 | |
| 90698 | <1% | 29 | $363.69 | |
| 20550 | <1% | 13 | $345.05 | |
| 97116 | <1% | 17 | $338.27 | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 1,171 | $272.15 |
| 99224 | <1% | 14 | $268.84 | |
| 73140 | <1% | 13 | $250.31 | |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 34 | $224.57 |
| 73130 | <1% | 14 | $195.31 | |
| 92553 | <1% | 14 | $192.66 | |
| 92550 | <1% | 13 | $184.77 | |
| 90744 | <1% | 25 | $157.28 | |
| 74018 | <1% | 12 | $144.63 | |
| 97139 | <1% | 19 | $140.78 | |
| 90723 | <1% | 15 | $91.62 | |
| 85018 | <1% | 25 | $69.54 | |
| 81001 | <1% | 18 | $38.86 | |
| 99173 | <1% | 13 | $20.77 | |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 12 | $19.30 |
| 99000 | <1% | 2,383 | $13.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 3,738 | $0.00 |
| 3079F | 0% | 349 | $0.00 | |
| 3074F | 0% | 7,247 | $0.00 | |
| 1036F | 0% | 614 | $0.00 | |
| H0049 | Alcohol and/or drug screening | 0% | 174 | $0.00 |
| 3078F | 0% | 5,719 | $0.00 | |
| 90461 | 0% | 636 | $0.00 | |
| 99072 | 0% | 105 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialANDERSON, DONALD (ASSISTANT SECRETARY OF ENROLLMENTS)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.