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 1255429338)

Providence Health & Services Oregon is a critical access hospital provider located in Hood River, Oregon. This profile covers 0 Medicare and 93 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	810 12th St
City	Hood River
State	OR
ZIP	97031
Taxonomy	Critical Access Hospital
NPI Enumerated	October 11, 2006

Payer Source	Total Paid
Medicaid	$8.8M
Medicare	$0

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

93 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	17,110	$240	$4.1M
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.	9,670	$300	$2.9M
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.	2,470	$290	$703.4K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	1,660	$50	$89.4K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	100	$790	$81.8K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	6,000	$10	$77.9K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	380	$190	$71.3K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	7,710	$10	$61.7K
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…	2,490	$20	$52.4K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	880	$60	$49.4K

Showing 1–10 of 93

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 — 0 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

93 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.	68	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.	67	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.	53	140	10,160	$130	$2.3M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	44	40	3,200	$60	$1.5M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	47	60	3,620	$90	$623.7K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	44	60	420	$60	$405.1K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	19	60	460	$40	$327.4K
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.	59	80	1,130	$90	$327.2K
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…	417	1,500	650	$70	$312.4K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	63	90	530	$50	$281.6K

Showing 1–10 of 93

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gregory Stanley	OR	Orthopaedic Surgery Physician	$226.1K	$0
Simona Braun	OR	Rheumatology Physician	$190K	$120
Darren Jones	OR	Clinical Cardiac Electrophysiology Physician	$123.2K	$0
Charles Cannan	AZ	Cardiovascular Disease Physician	$114K	$0
Aly Rahimtoola	OR	Cardiovascular Disease Physician	$102.9K	$0
Amelia Servin	OR	Emergency Medicine Physician	$90K	$0
Kevin Woolf	OR	Cardiovascular Disease Physician	$86.9K	$0
Alexander Morss	OR	Cardiovascular Disease Physician	$86.6K	$0
Kristina Moon	OR	Cardiovascular Disease Physician	$84.7K	$0
Geoffrey Wilson	OR	Cardiovascular Disease Physician	$80.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
One Community Health	OR	Federally Qualified Health Center (FQHC)	$0	$4.4M
Sarah Mcdonnell LLC	OR	Rehabilitation Clinic/Center	$0	$3.1M
The Next Door, Inc.	OR	Community/Behavioral Health Agency	$0	$1.6M
Columbia Pain Management, Inc.	OR	Interventional Pain Medicine Physician	$0	$1.1M
One Community Health	OR	Federally Qualified Health Center (FQHC)	$0	$1.1M
City Of Hood River	OR	Land Ambulance	$204.8K	$303.6K
Aaron Loyd	OR	Dermatopathology Physician	$329.8K	$0
David Russo	OR	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$294.2K	$0
Holly Tumelson	OR	Physician Assistant	$234.7K	$0
Trey Rigert	OR	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$197.1K	$0

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

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