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.

A Balanced Life Health Care (NPI 1083040869)

Field	Value
Entity Type	Organization
Organization	A Balanced Life Health Care
Address	2005 Se Hawthorne Blvd
City	Portland
State	OR
ZIP	97214
Taxonomy	Health Maintenance Organization
NPI Enumerated	September 24, 2013

Payer Source	Total Paid
Medicaid	$963.1K
Medicare	$0

Medicaid: Complete Services Breakdown

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

16 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…	5,260	$110	$573.1K
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…	1,520	$150	$227.6K
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…	1,040	$80	$78.7K
99354	N/A	260	$100	$25.7K
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…	110	$160	$17.6K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	110	$100	$11K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	2,010	$10	$10.1K
99072	The provider uses items, supplies materials, or requires clinical staff time in excess of what is normally used or provided for an office visit or other nonfacility encounter. These additional items…	1,780	$10	$8.9K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	50	$110	$4.9K
97810	The provider uses solid, metallic, fine, single–use needles to pierce the skin and stimulate anatomical points on or in the skin by manipulating the needles by hand during an initial 15 minute…	50	$40	$1.7K

Showing 1–10 of 16

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

A Balanced Life Health Care — 0 of 15 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

16 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…	274	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…	635	1,590	590	$50	$236.5K
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…	74	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…	239	530	80	$120	$68.5K
97810	The provider uses solid, metallic, fine, single–use needles to pierce the skin and stimulate anatomical points on or in the skin by manipulating the needles by hand during an initial 15 minute…	147	170	680	$30	$47.4K
97811	The provider pierces the skin using one or more needles and stimulates anatomical points on or in the skin by manipulating the needles by hand. This code represents each additional 15 minutes of…	148	170	680	$20	$39.9K
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,…	477	570	110	$50	$37.6K
99354	N/A	14	50	130	$90	$23.3K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	216	420	520	$1	$20K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	21	80	40	$90	$18.5K

Showing 1–10 of 16

Nearby Providers

Other providers in the same ZIP code as A Balanced Life Health Care, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Coda, Inc.	OR	Substance Abuse Rehabilitation Facility	$442.9K	$81M
American Medical Response Northwest Inc	OR	Ambulance	$4.4M	$62M
Volunteers Of America Inc.	OR	Contractor	$0	$33.6M
Native American Rehabilitation Assoc Inc	OR	Federally Qualified Health Center (FQHC)	$0	$32.5M
Crc Health Oregon, LLC	OR	Methadone Clinic	$177.6K	$24.3M
Advanced Wellness Center	OR	Multi-Specialty Clinic/Center	$0	$5M
Larsen Sanchez Psychology, LLC	OR	Clinical Psychologist	$0	$4.4M
Tiffany Kettermann, LLC	OR	Mental Health Counselor	$0	$4.2M
Center For Natural Medicine, Inc	OR	Multi-Specialty Clinic/Center	$0	$4.1M
Climb Behavioral Solutions, LLC	OR	Behavior Analyst	$0	$3.9M

A Balanced Life Health Care — Billing Profile & Reimbursement Data

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A Balanced Life Health Care — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References