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NPI 1053311860 · Portland, OR · Multi-Specialty Clinic/Center
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Planned Parenthood Of The Columbia/willamette, Inc. is a multi-specialty clinic/center provider located in Portland, Oregon. This profile covers 0 Medicare and 46 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Planned Parenthood Of The Columbia/willamette, Inc. |
| Address | 3727 Ne Martin Luther King Jr Blvd |
| City | Portland |
| State | OR |
| ZIP | 97212 |
| Taxonomy | Multi-Specialty Clinic/Center |
| NPI Enumerated | July 22, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $20.3M |
| Medicare | $0 |
This provider is effectively a single-payer Medicaid operator: there is no Medicare billing on file and lifetime Medicaid revenue is $20.3M. The absence of Medicare activity alongside substantial Medicaid receipts indicates the organization’s patient mix and reimbursement exposure are concentrated in state Medicaid programs rather than fee-for-service Medicare populations.
Revenue is highly concentrated in a small set of services: the precomputed top 3 Medicaid codes by revenue account for 73.4% of this provider's total Medicaid revenue. The three largest contributors are T1015 (31.1%), S4993 (30.0%), and 99213 (12.2%), identifying a narrow set of visit and contraceptive-related codes that drive the bulk of reported Medicaid dollars.
Code mix and volumes indicate a family-planning, high-throughput clinic model: T1015 (41.3K claims, $152 avg/claim), S4993 (57.7K claims, $105 avg/claim), and large counts of pregnancy tests 81025 (54.4K claims, $7 avg/claim) and lab tests 87801 (12.4K claims, $17 avg/claim) point to routine clinic visits, contraceptive dispensing, and on-site diagnostic screening as core operations. High claim counts for contraceptive supplies and procedures (J7307, J7298, J7300, A4267) further support an emphasis on contraceptive services and supply distribution rather than specialty procedural revenue.
The provider is a dominant statewide player on multiple Medicaid codes: T1015 ranks #1 of 62 providers in-state (100th percentile; extreme outlier) and S4993 ranks #1 of 28 providers in-state (100th percentile; extreme outlier), indicating market leadership in clinic-visit and contraceptive-pill volume. J7307 and several testing and supply codes also sit at or near the top of state rankings (many 100th-percentile placements), so the provider’s competitive strength is concentrated in family-planning and preventive-care lines rather than broad ambulatory care.
While some E&M activity is very high-volume, its relative rank for standard outpatient E&M is mixed: 99213 shows substantial volume (39.7K claims, $62 avg/claim) and ranks #42 of 1591 providers in-state (97th percentile; notably above typical state volume), demonstrating strong primary outpatient throughput, but other E&M codes like 99214 and 99203 appear at more typical state percentiles. This pattern suggests a mix of high-volume low-acuity visits alongside a smaller share of higher-complexity visits.
Operational profile shows a mix of high-volume, low-unit-price services and targeted higher-cost contraceptive procedures: the dataset includes very large counts of low-paid items (A4267 condoms 26.6K claims at $4 avg/claim; 36416 fingerstick 19.8K claims at $2 avg/claim) alongside concentrated higher-unit reimbursements for implants and IUDs (J7307 2.9K claims at $396 avg/claim; J7298 2.2K claims at $231 avg/claim). That combination aligns with a clinic that provides both routine preventive supplies and episodic device-based contraception.
The provider’s Medicaid concentration and revenue concentration create exposure to Medicaid policy or utilization shifts: with $20.3M in Medicaid receipts and 73.4% of that revenue tied to three codes, changes in reimbursement, prior authorization, or utilization for T1015, S4993, or 99213 would have outsized financial impact. Analysts should treat reimbursement policy and state program edits for those specific codes as primary levers of revenue risk.
The organization is an established entity with a long NPI tenure, enumerated/registered since 2005-07-22 (~21 years ago), which supports the interpretation that these billing patterns reflect a stable, mature service model rather than a new entrant. Longevity combined with extreme outlier rankings on multiple family-planning codes suggests sustained specialization in reproductive and preventive health services within the state Medicaid market.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
46 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 41,320 | $150 | $6.3M |
| S4993 | Contraceptive pills for birth control | 57,660 | $110 | $6.1M |
| 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… | 39,730 | $60 | $2.5M |
| J7307 | Etonogestrel (contraceptive) implant system, including implant and supplies | 2,920 | $400 | $1.2M |
| 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… | 10,190 | $60 | $570.7K |
| J7298 | Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg | 2,210 | $230 | $510.7K |
| 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,… | 9,310 | $40 | $409.5K |
| 81025 | The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout. | 54,430 | $10 | $381K |
| 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… | 4,160 | $90 | $361.9K |
| S9430 | Pharmacy compounding and dispensing services | 4,390 | $70 | $324.9K |
Showing 1–10 of 46
How this provider's Medicaid billing volume and revenue compare to other Oregon providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Oregon median
46 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| S4993 | Contraceptive pills for birth control | 1 | 30 | 190 | $110 | $414.9K |
| 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… | 322 | 1,500 | 650 | $70 | $312.4K |
| T1015 | Clinic visit/encounter, all-inclusive | 1 | 60 | 480 | $120 | $291K |
| J7307 | Etonogestrel (contraceptive) implant system, including implant and supplies | 1 | 10 | 50 | $420 | $287.4K |
| S9430 | Pharmacy compounding and dispensing services | 1 | 10 | 2,220 | $110 | $245.2K |
| 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… | 42 | 1,590 | 590 | $50 | $236.5K |
| J7298 | Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg | 1 | 10 | 280 | $270 | $189.8K |
| 87389 | The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an… | 12 | 50 | 280 | $20 | $120.7K |
| 87801 | The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique. | 2 | 30 | 60 | $40 | $104.8K |
| 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… | 41 | 600 | 120 | $80 | $83.3K |
Showing 1–10 of 46
Other providers in the same ZIP code as Planned Parenthood Of The Columbia/willamette, Inc., ranked by combined Medicare and Medicaid revenue.
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