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.

Grande Ronde Recovery (NPI 1093998866)

Field	Value
Entity Type	Organization
Organization	Grande Ronde Recovery
Address	1101 I Ave
City	La Grande
State	OR
ZIP	97850
Taxonomy	Addiction Psychiatry Physician
NPI Enumerated	December 14, 2007

Payer Source	Total Paid
Medicaid	$3.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	21,870	$50	$1.1M
H0005	Alcohol and/or drug services; group counseling by a clinician	18,940	$40	$833.4K
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…	10,110	$80	$768.2K
H0006	Alcohol and/or drug services; case management	16,380	$20	$278.4K
H0038	Self‑help/peer services, per 15 minutes	5,210	$50	$244.6K
H0048	Alcohol and/or other drug testing: collection and handling only, specimens other than blood	9,790	$10	$107.7K
H0001	Alcohol and/or drug assessment	440	$130	$57.2K
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…	370	$70	$24.2K
H0002	Behavioral health screening to determine eligibility for admission to treatment program	280	$40	$10.4K
90849	In this procedure, the provider performs a psychotherapy session with a group of patients’ families.	150	$40	$5.5K

Showing 1–10 of 13

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

Grande Ronde Recovery — 1 of 11 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

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0005	Alcohol and/or drug services; group counseling by a clinician	34	180	3,250	$40	$783.8K
H0004	Behavioral health counseling and therapy, per 15 minutes	21	270	1,660	$90	$681K
H0038	Self‑help/peer services, per 15 minutes	37	150	1,030	$80	$417.2K
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…	889	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…	157	1,590	590	$50	$236.5K
H0048	Alcohol and/or other drug testing: collection and handling only, specimens other than blood	43	160	2,750	$20	$205.1K
T1016	Case management, each 15 minutes	129	210	410	$50	$126.4K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	135	140	310	$60	$113.6K
H0001	Alcohol and/or drug assessment	20	100	80	$140	$70.6K
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.	128	210	150	$60	$59.2K

Showing 1–10 of 13

Nearby Providers

Other providers in the same ZIP code as Grande Ronde Recovery, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grande Ronde Hospital, Inc.	OR	Critical Access Hospital	$0	$20.1M
Union County	OR	Case Management Agency	$0	$4.8M
Norco, Inc	OR	Durable Medical Equipment & Medical Supplies	$0	$1.5M
Assure Drug Detection LLC	OR	Clinical Medical Laboratory	$0	$1.3M
William Pettit	OR	Ophthalmology Physician	$1.1M	$94K
City Of La Grande	OR	Land Ambulance	$415.8K	$693.3K
Mountain Valley Therapy, Inc	OR	Physical Therapist	$0	$1.1M
Lincare Inc	OR	Durable Medical Equipment & Medical Supplies	$0	$1M
Center For Human Development, Inc	OR	Public Health or Welfare Agency	$65.3K	$559K
Daniel Kirkham	OR	Diagnostic Radiology Physician	$217.9K	$0

Grande Ronde Recovery — Billing Profile & Reimbursement Data

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Grande Ronde Recovery — 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