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.

The Oregon Clinic PC (NPI 1265417174)

The Oregon Clinic PC is a specialist provider located in Portland, Oregon. This profile covers 0 Medicare and 85 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	The Oregon Clinic PC
Address	541 Ne 20th Ave
City	Portland
State	OR
ZIP	97232
Taxonomy	Specialist
NPI Enumerated	December 13, 2005

Payer Source	Total Paid
Medicaid	$7.4M
Medicare	$0

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

85 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99203	The provider sees a new 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 provider…	13,970	$100	$1.4M
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…	24,750	$60	$1.4M
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…	8,350	$140	$1.1M
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…	6,210	$140	$870K
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…	9,260	$80	$722.6K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	1,330	$200	$271.3K
41010	In this procedure, the provider makes an incision in the lingual frenum, a membranous ridge under the tongue, to allow greater movement of the tongue in patients with ankyloglossia.	1,370	$170	$237.2K
95811	During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.	510	$250	$125.7K
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,…	3,160	$40	$113.6K
16020	This CPT code is for the dressing and/or debridement of a partial–thickness burn (either initially or subsequently). In this instance the burn is small (less than 5% of the total body surface area).	1,740	$70	$113.2K

Showing 1–10 of 85

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

The Oregon Clinic PC — 7 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

85 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	4	40	380	$130	$326.9K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	34	40	310	$420	$325.7K
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…	169	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…	41	90	530	$50	$281.6K
E0601	Continuous positive airway pressure (CPAP) device	83	80	2,470	$70	$281K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	38	60	350	$260	$251.9K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	35	50	200	$370	$238.2K
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…	65	1,590	590	$50	$236.5K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	6	10	30	$2,290	$236.2K
95811	During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.	9	20	280	$370	$197.9K

Showing 1–10 of 85

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Portland Gastroenterology Equipment	OR	Endoscopy Clinic/Center	$806.3K	$5.7M
Gso Equipment Corp	OR	Endoscopy Clinic/Center	$528K	$1.2M
Gso Equipment Corp	OR	Endoscopy Clinic/Center	$291.4K	$998.3K
Gso Equipment Corp	OR	Endoscopy Clinic/Center	$218.2K	$306.2K
Ken Lee	OR	MOHS-Micrographic Surgery Physician	$459.6K	$0
Sandeep Garg	OR	Cardiovascular Disease Physician	$303.4K	$0
Peter Banitt	OR	Interventional Cardiology Physician	$189K	$0
Sajal Dutta	OR	Urology Physician	$185.5K	$0
Lance Marr	OR	Urology Physician	$152.1K	$0
Jennifer Kuhn	OR	Nurse Practitioner	$148.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kaiser Foundation Health Plan Of The Northwest	OR	General Practice Physician	$0	$116.3M
Cascadia Health	OR	Multi-Specialty Clinic/Center	$0	$76.8M
Legacy Emanuel Hospital & Health Center	OR	General Acute Care Hospital	$0	$50.8M
Legacy Laboratory Services, LLC	OR	Clinical Medical Laboratory	$2.8M	$24.8M
Kaiser Foundation Health Plan Of The Northwest	OR	General Practice Dentistry	$0	$6.9M
Laboratory Corporation Of America	OR	Clinical Medical Laboratory	$348.3K	$2.7M
Restore Therapy LLC	OR	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$2.9M
Cascade Pathology Services, Corp	OR	Anatomic Pathology & Clinical Pathology Physician	$0	$2.5M
Pacific Northwest Renal Services, L.L.C.	OR	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2M
Cascade Cytology Reference	OR	Anatomic Pathology & Clinical Pathology Physician	$0	$1.1M

The Oregon Clinic PC — Billing Profile & Reimbursement Data

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The Oregon Clinic PC — 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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