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 1295105518)

Field	Value
Entity Type	Organization
Organization	Providence Health & Services - Oregon
Address	830 Ne 47th Ave
City	Portland
State	OR
ZIP	97213
Taxonomy	Child & Adolescent Psychiatry Physician
NPI Enumerated	September 29, 2015

Payer Source	Total Paid
Medicaid	$8.7M
Medicare	$0

Medicaid: Complete Services Breakdown

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

39 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	40,510	$70	$2.9M
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	25,190	$110	$2.8M
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…	8,650	$140	$1.2M
97803	The provider reassesses the dietary needs of a patient and uses specific diet therapy to treat medical conditions and related symptoms by interacting individually with the patient. This code…	4,010	$120	$473.3K
99205	The provider sees a new 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 provider…	990	$210	$211.9K
97802	The provider treats medical conditions and related symptoms using specific diet therapy by interacting individually with the patient. This code represents each 15 minutes of the first visit with the…	1,300	$140	$178.5K
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	1,850	$80	$148K
92579	The provider performs a battery of tests to evaluate hearing loss in infants and toddlers. He uses sound sources to evaluate the auditory response, with reinforcement by animated toys.	2,170	$40	$90.9K
92567	In this procedure, the provider measures the functioning of the middle ear by varying the pressure of air presented to the ear to identify the reason for hearing loss.	5,930	$10	$83K
92582	The provider measures the type and severity of hearing loss in a young child, generally two to four years of age without any developmental or physical impairment. He analyzes the patient’s response…	1,230	$60	$78.7K

Showing 1–10 of 39

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 — 8 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

39 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	5	80	1,420	$60	$368.8K
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…	862	1,500	650	$70	$312.4K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	8	290	770	$60	$252K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	216	350	760	$30	$116.5K
96131	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	4	30	70	$260	$99.6K
92587	Code 92587 is in the Medicine/Special Otorhinolaryngologic Services Section. It involves special procedures of the ears/nose/throat. This code is for screening purposes with interpretation and…	2	10	40	$110	$88K
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…	541	600	120	$80	$83.3K
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…	4	530	150	$110	$74.9K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	11	20	80	$150	$68.6K
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…	274	530	80	$120	$68.5K

Showing 1–10 of 39

Related Providers

Other providers that share a Tax Identification Number (TIN) with Providence Health & Services - Oregon, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Providence Health & Services - Oregon	OR	General Acute Care Hospital	$0	$36.9M
Providence Health & Services - Oregon	OR	Clinical Pathology Physician	$0	$11.4M
Salem Pediatric Clinic	OR	Pediatrics Physician	$0	$9M
Providence Health & Services - Oregon	OR	Internal Medicine Physician	$0	$4.6M
Providence Health & Services - Oregon	OR	Internal Medicine Physician	$0	$3.8M
Providence Health & Services - Oregon	OR	Clinic/Center	$0	$3.6M
Providence Health & Services Oregon	OR	Internal Medicine Physician	$0	$3M
Providence Health & Services - Oregon	OR	Family Medicine Physician	$0	$2.7M
Providence Health & Services - Oregon	OR	Family Medicine Physician	$0	$2.7M
Express Care Or PC	OR	General Practice Physician	$0	$2.4M

Nearby Providers

Other providers in the same ZIP code as Providence Health & Services - Oregon, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Providence Health & Services - Oregon	OR	General Acute Care Hospital	$0	$49M
Providence Health & Services Oregon	OR	Durable Medical Equipment & Medical Supplies	$0	$45.5M
Providence Health & Services - Oregon	OR	Clinical Pathology Physician	$0	$13.7M
Providence Health & Services Oregon	OR	Home Infusion Therapy Pharmacy	$0	$9.8M
Radiology Specialists Of The Northwest, PC	OR	Diagnostic Radiology Physician	$0	$5.7M
Laboratory Corporation Of America	OR	Clinical Medical Laboratory	$1.4M	$3.2M
Uptown Providers Inc	OR	Urgent Care Clinic/Center	$0	$2.8M
Credena Health LLC	OR	Specialty Pharmacy	$0	$2.5M
Oregon Pediatrics Ne Portland PC	OR	Pediatrics Physician	$0	$2.2M
Behavioral Learning Network - Oregon LLC	OR	Behavior Analyst	$0	$1.8M

Providence Health & Services - Oregon — Billing Profile & Reimbursement Data

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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

Related Providers

Nearby Providers

Frequently Asked Questions

References