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.

Northwest Acute Care Specialists PC (NPI 1215983200)

Key Findings

Field	Value
Entity Type	Organization
Organization	Northwest Acute Care Specialists PC
Address	101 Sw Main St Ste 940
City	Portland
State	OR
ZIP	97204
Taxonomy	Emergency Medicine Physician
NPI Enumerated	May 25, 2006

Payer Source	Total Paid
Medicaid	$42.6M
Medicare	$0

This practice effectively operates as a Medicaid-only billing entity: there is no Medicare billing on file and total Medicaid revenue is $42.6M. The absence of Medicare activity makes the provider functionally single-payer at present, which has implications for network participation and revenue diversification strategies.

Revenue is highly concentrated in three emergency department E/M codes: 99284 (244.2K claims, $82 avg paid/claim, $20M revenue; 47.0% of this provider's total Medicaid revenue), 99285 (175K claims, $105 avg paid/claim, $18.4M revenue; 43.1% of this provider's total Medicaid revenue), and 99283 (74.6K claims, $49 avg paid/claim, $3.7M revenue; 8.6% of this provider's total Medicaid revenue). Precomputed analysis confirms those top three codes together account for 98.7% of the provider's Medicaid revenue, indicating extreme dependence on ED evaluation-and-management services.

The code mix (dominance of 99284 and 99285 with substantial 99283 volume) signals an emergency-department-focused operation that treats a broad acuity range from low to high medical decision making. High volumes of 99285 specifically point to frequent high-acuity ED encounters, while continued 99283 volume shows throughput across lower-acuity ED visits.

State-level competitive standing for core ED services is dominant: the provider ranks #1 of 145 for 99284 and #1 of 129 for 99285, both at the 100th percentile and described as "extreme outlier, far above typical state volume for this code." These rankings identify the provider as a major statewide outlier for moderate- and high-complexity ED visits, not a modest participant.

For lower-acuity ED visits, the provider still reports above-typical volume: 99283 is 74.6K claims with $3.7M revenue and ranks #3 of 137 in-state (99th percentile; notably above typical state volume for this code). That rank profile indicates the provider captures high volumes across the acuity spectrum within the emergency setting rather than concentrating only at one level of complexity.

Ancillary service patterns align with heavy ED throughput: 93010 shows 93.1K claims, $4 avg paid/claim, $372.3K revenue (0.9% of Medicaid revenue) and ranks #3 of 141 in-state (99th percentile; extreme outlier), indicating very high ECG volume consistent with emergency care. Similarly, 99053 has 53.3K claims, $1 avg paid/claim, $53.3K revenue (0.1%) and ranks #1 of 5 in-state (100th percentile; notably above typical state volume), suggesting substantial overnight/24-hour facility coverage activity.

Clinical intensity beyond routine ED E/M appears limited as a revenue driver: 99291 shows 1K claims, $118 avg paid/claim, $118.1K revenue (0.3% of Medicaid revenue) and ranks #13 of 41 in-state (70th percentile; typical, unremarkable volume). This pattern indicates some critical care services are provided but they are not a primary source of Medicaid revenue for this provider.

The provider has long operational tenure with NPI enumeration on 2006-05-25 (~20 years ago), which supports the interpretation of an established emergency services operation. Given the $42.6M in Medicaid revenue and the 98.7% concentration in three ED E/M codes, the business faces both negotiating leverage in Medicaid ED contracts and concentration risk if payer policy or coding patterns shift for those core codes.

Medicaid: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	244,170	$80	$20M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	174,970	$110	$18.4M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	74,630	$50	$3.7M
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	93,090	$1	$372.3K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	1,000	$120	$118.1K
99053	The provider renders overnight services at a 24 hour facility.	53,340	$1	$53.3K
93042	The provider interprets a recording of the electrical conduction of the heart to examine any abnormality in its functioning using a maximum of three leads, wires that connect the recording device to…	1,730	$1	$6.9K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	1,150	$1	$2.3K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	10	$120	$1.4K
93308	The provider performs a limited or follow–up transthoracic echocardiography to obtain a two dimensional (2D) image of the heart through the chest wall. It is a limited examination of a focused…	70	$20	$980

Showing 1–10 of 15

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

Northwest Acute Care Specialists PC — 6 of 14 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

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	1	150	7,400	$170	$2.8M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	1	130	2,610	$200	$2.3M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	3	140	10,160	$130	$2.3M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	82	80	1,130	$90	$327.2K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	13	40	380	$130	$326.9K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	54	110	1,150	$10	$91.4K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	74	80	110	$100	$89.6K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	88	150	480	$10	$68.6K
76705	An abdominal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. liver, gallbladder, pancreas, bile ducts, spleen, and abdominal aorta). This particular code…	52	60	340	$30	$50.6K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	3	140	710	$10	$48.7K

Showing 1–10 of 15

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northwest Acute Care Specialists PC	WA	Emergency Medicine Physician	$0	$11.9M
Jason Bell	OR	Orthopaedic Surgery Physician	$118K	$17.5K
Rebecca Dorsey	OR	Psychiatric/Mental Health Nurse Practitioner	$75.7K	$1.8K
Jerry Lawrence	OR	Emergency Medicine Physician	$74.3K	$0
Scott Fleck	OR	Medical Physician Assistant	$73.3K	$0
Tao Zhu	OR	Emergency Medicine Physician	$60K	$0
Mark Moylan	OR	Emergency Medicine Physician	$58.7K	$0
Alexandra Herndon	WA	Emergency Medicine Physician	$18.8K	$29.5K
Garth Barbee	OR	Emergency Medicine Physician	$37.8K	$0
Marc Houston	OR	Emergency Medicine Physician	$35.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Boulder Care Provider Group PA	OR	Addiction Medicine (Family Medicine) Physician	$0	$6.7M
Norma Furlong	OR	Family Nurse Practitioner	$20.2K	$0

Northwest Acute Care Specialists PC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References