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

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

Providence Health & Services - Oregon (NPI 1053419218)

Providence Health & Services - Oregon is a family medicine physician provider located in Gresham, Oregon. This profile covers 0 Medicare and 36 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	Providence Health & Services - Oregon
Address	440 Nw Division St
City	Gresham
State	OR
ZIP	97030
Taxonomy	Family Medicine Physician
NPI Enumerated	September 20, 2006

Payer Source	Total Paid
Medicaid	$1.3M
Medicare	$0

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

36 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…	15,750	$50	$834.5K
97803	The provider reassesses the dietary needs of a patient and uses specific diet therapy to treat medical conditions and related symptoms by interacting individually with the patient. This code…	3,320	$80	$272.3K
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…	1,700	$50	$86.5K
96158	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of a patient’s physical health…	1,200	$40	$52.7K
G0108	Diabetes outpatient self-management training services, individual, per 30 minutes	390	$50	$20.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	110	$120	$13.4K
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…	1,060	$10	$11.7K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	100	$90	$8.9K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	60	$150	$8.3K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	650	$10	$7.2K

Showing 1–10 of 36

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Oregon Distribution

Providence Health & Services - Oregon — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oregon

Full comparison — all codes billed, vs. Oregon median

36 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	100	1,500	650	$70	$312.4K
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…	512	1,590	590	$50	$236.5K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	393	400	230	$90	$153.8K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	167	310	280	$70	$82K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	304	530	150	$110	$74.9K
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…	432	530	80	$120	$68.5K
97803	The provider reassesses the dietary needs of a patient and uses specific diet therapy to treat medical conditions and related symptoms by interacting individually with the patient. This code…	4	70	210	$70	$52.1K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	87	190	60	$200	$45.6K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	151	370	60	$110	$41.7K
83036	Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).…	135	160	610	$10	$41.6K

Showing 1–10 of 36

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Legacy Mount Hood Medical Center	OR	General Acute Care Hospital	$0	$43.2M
Telecare Mental Health Services Of Oregon, Inc	OR	Mental Illness Community Based Residential Treatment Facility	$0	$12M
The Evangelical Lutheran Good Samaritan Society	OR	In Home Supportive Care Agency	$0	$5M
Calcagno Pediatrics PC	OR	Pediatrics Physician	$0	$5M
Mtn. View Family Practice, PC	OR	Family Medicine Physician	$0	$1.8M
Jiyoung E Lee Dmd PC	OR	Pediatric Dentistry	$0	$1.6M
Performance Modalities Inc	OR	Oxygen Equipment & Supplies (DME)	$0	$1.4M
Legacy Mount Hood Medical Center	OR	Clinic/Center	$0	$1.1M
Columbia Pain And Spine Institute	OR	Physical Medicine & Rehabilitation Physician	$0	$1M
Ana Squellati	OR	Naturopath	$0	$959K

Providence Health & Services - Oregon — Billing Profile & Reimbursement Data

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Providence Health & Services - Oregon — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Providence Health & Services - Oregon	OR	General Acute Care Hospital	$0	$36.9M
Providence Health & Services - Oregon	OR	Clinical Pathology Physician	$0	$11.4M
Salem Pediatric Clinic	OR	Pediatrics Physician	$0	$9M
Providence Health & Services - Oregon	OR	Child & Adolescent Psychiatry Physician	$0	$8.7M
Providence Health & Services - Oregon	OR	Internal Medicine Physician	$0	$4.6M
Providence Health & Services - Oregon	OR	Internal Medicine Physician	$0	$3.8M
Providence Health & Services - Oregon	OR	Clinic/Center	$0	$3.6M
Providence Health & Services Oregon	OR	Internal Medicine Physician	$0	$3M
Providence Health & Services - Oregon	OR	Family Medicine Physician	$0	$2.7M
Providence Health & Services - Oregon	OR	Family Medicine Physician	$0	$2.7M