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.

Legacy Emanuel Hospital & Health Center (NPI 1316129232)

Legacy Emanuel Hospital & Health Center is a rural health clinic/center provider located in Saint Helens, Oregon. This profile covers 0 Medicare and 28 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	Legacy Emanuel Hospital & Health Center
Address	475 S Columbia River Hwy Ste 100
City	Saint Helens
State	OR
ZIP	97051
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	December 3, 2007

Payer Source	Total Paid
Medicaid	$1.8M
Medicare	$0

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

28 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	13,620	$80	$1.1M
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…	4,590	$70	$321.4K
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…	1,890	$110	$199.8K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	560	$60	$36K
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	1,960	$10	$21.5K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	130	$130	$17.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	160	$110	$17K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	790	$20	$14.2K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	100	$110	$10.3K
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…	60	$130	$7.4K

Showing 1–10 of 28

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

Legacy Emanuel Hospital & Health Center — 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

28 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	110	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…	279	1,590	590	$50	$236.5K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	125	170	300	$80	$133.1K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	118	180	220	$90	$124.6K
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…	570	600	120	$80	$83.3K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	104	310	280	$70	$82K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	87	170	170	$90	$78.3K
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…	53	530	150	$110	$74.9K
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…	319	530	80	$120	$68.5K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	128	370	60	$110	$41.7K

Showing 1–10 of 28

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Legacy Emanuel Hospital & Health Center	OR	General Acute Care Hospital	$0	$64.2M
Legacy Emanuel Hospital & Health Center	OR	General Acute Care Hospital	$0	$50.8M
Legacy Clinics LLC	OR	Clinic/Center	$35.6K	$48.7M
Legacy Mount Hood Medical Center	OR	General Acute Care Hospital	$0	$43.2M
Union Associated Physicians Clinic, LLC	IN	Family Medicine Physician	$0	$31.1M
Legacy Emanuel Hospital & Health Center	OR	Clinic/Center	$0	$17M
Legacy Salmon Creek Hospital	WA	Clinic/Center	$0	$9.9M
Legacy Emanuel Hospital & Health Center	OR	Clinic/Center	$0	$1.5M
Sandeep Garg	OR	Cardiovascular Disease Physician	$303.4K	$0
Randall Harada	WA	Interventional Cardiology Physician	$303.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbia Community Mental Health	OR	Mental Health Counselor	$0	$12.6M
Medicine Wheel Recovery Services, Inc.	OR	Community/Behavioral Health Agency	$0	$6.8M
Bridge To Pathways	OR	Substance Abuse Rehabilitation Facility	$0	$2.4M
Columbia River Fire & Rescue	OR	Land Ambulance	$266.4K	$1.4M
Heather Dryden	OR	Internal Medicine Physician	$63.2K	$0

Legacy Emanuel Hospital & Health Center — Billing Profile & Reimbursement Data

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Legacy Emanuel Hospital & Health Center — 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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