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.

Lane County Oregon (NPI 1326138314)

Field	Value
Entity Type	Organization
Organization	Lane County Oregon
Address	2073 Olympic St
City	Springfield
State	OR
ZIP	97477
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	October 13, 2006

Payer Source	Total Paid
Medicaid	$20.6M
Medicare	$0

Key Findings

This provider is effectively a single‑payer Medicaid operator: there is no Medicare billing on file and total Medicaid revenue is $20.6M, indicating the organization’s financial scale is concentrated in the Medicaid program rather than a mixed Medicare/Medicaid mix. Analysts should treat Medicaid as the primary payer when evaluating this entity’s service footprint and contracting leverage.

The NPI was enumerated on 2006-10-13 (approximately ~20 years ago), indicating long-standing participation in public programs; that tenure supports the idea that current billing patterns reflect an established operational model rather than a new program rollout.

Revenue concentration is high: the top 3 Medicaid codes by revenue account for 53.3% of this provider’s total Medicaid revenue. Those top drivers are 99214 ($4.4M, 23.0%), H0020 ($3.2M, 16.7%), and 90832 ($2.6M, 13.6%), showing a small number of codes generate the majority of Medicaid dollars.

The code mix points to an integrated primary care and behavioral health operation with a significant medication‑assisted treatment (MAT) component. High revenue from 99214 (established outpatient E/M), large volume and revenue for 90832 (individual psychotherapy) and extensive H0020 billing (methadone administration/services) together suggest the site operates both routine primary care workflows and high-volume behavioral health/SUD treatment services.

State competitive standing is strong on multiple high-revenue codes: 99214 ranks #5 of 1503 in-state (100th percentile; extreme outlier) and 90832 ranks #1 of 311 (100th percentile; extreme outlier), indicating this provider is a dominant in-state source for moderate complexity E/M visits and short individual psychotherapy. Additional E/M and behavioral health codes such as 99213 (#13 of 1591, 99th percentile; extreme outlier) and 99215 (#2 of 531, 100th percentile; extreme outlier) further underscore that the provider far exceeds typical state volumes for core outpatient visit types.

Beyond the top three, the provider reports very large volumes and notable ranks across a broad set of behavioral health, SUD, and supportive service codes — for example, H0020 has 167.3K claims, 90832 has 37.5K claims, D0191 has 40.2K claims and ranks #2 of 234 (100th percentile; extreme outlier), and G0177 ranks #1 of 21 (100th percentile; extreme outlier). These patterns point to substantial throughput in counseling, group/self‑help, testing, and related ancillary services that support a high-capacity behavioral health program.

Operationally, the raw claim counts signal high visit and service volumes: 99214 shows 118.3K claims and H0020 shows 167.3K claims, consistent with continuous, high-frequency service delivery rather than episodic care. For payers or network managers, these volumes imply the provider is a major operational site for scheduled outpatient and medication‑dispensing encounters that will materially affect utilization forecasts and network capacity planning.

For payer strategy and contracting, the absence of Medicare activity combined with concentrated Medicaid revenue and documented in‑state dominance on multiple BH and E/M codes suggests opportunities and risks specific to Medicaid. Payors evaluating partnerships or value‑based arrangements should treat this entity primarily as a Medicaid behavioral health and MAT anchor with exceptional scale in certain codes, and should expect negotiations and utilization management to hinge on 99214, H0020, and 90832 given their combined 53.3% share of Medicaid revenue.

Medicaid: Complete Services Breakdown

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

131 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…	118,320	$40	$4.4M
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	167,260	$20	$3.2M
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…	37,490	$70	$2.6M
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…	91,660	$30	$2.3M
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	9,440	$120	$1.2M
H0004	Behavioral health counseling and therapy, per 15 minutes	15,820	$60	$933.3K
90834	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…	4,960	$90	$436.5K
D0191	N/A	40,220	$10	$321.8K
H0038	Self‑help/peer services, per 15 minutes	8,610	$40	$318.7K
H0005	Alcohol and/or drug services; group counseling by a clinician	9,000	$40	$315.1K

Showing 1–10 of 131

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

Lane County Oregon — 10 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

131 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	13	30	86,800	$10	$2.4M
H0005	Alcohol and/or drug services; group counseling by a clinician	58	180	3,250	$40	$783.8K
H0004	Behavioral health counseling and therapy, per 15 minutes	35	270	1,660	$90	$681K
H0038	Self‑help/peer services, per 15 minutes	25	150	1,030	$80	$417.2K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	81	1,380	540	$140	$363.3K
H2014	Skills training and development, per 15 minutes	28	120	1,010	$40	$323.2K
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…	5	1,500	650	$70	$312.4K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	48	80	1,210	$40	$294.3K
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…	13	1,590	590	$50	$236.5K
H0048	Alcohol and/or other drug testing: collection and handling only, specimens other than blood	27	160	2,750	$20	$205.1K

Showing 1–10 of 131

Nearby Providers

Other providers in the same ZIP code as Lane County Oregon, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mckenzie-willamette Regional Medical Center Associates LLC	OR	General Acute Care Hospital	$0	$44.6M
Peacehealth	OR	General Acute Care Hospital	$0	$30.7M
Springfield Treatment Center	OR	Methadone Clinic	$0	$20.5M
Mental Health For Children, Inc	OR	Mental Health Counselor	$0	$12.7M
G Street Integrated Health	OR	Clinic/Center	$0	$9.3M
Radiology Associates PC	OR	Diagnostic Radiology Physician	$0	$7.8M
Oregon Endoscopy Center, LLC	OR	Ambulatory Surgical Clinic/Center	$919.2K	$5.6M
Pathology Consultants, PC	OR	Anatomic Pathology & Clinical Pathology Physician	$0	$5.5M
Peacehealth	OR	Hospitalist Physician	$0	$5.5M
Womens Care, PC	OR	Obstetrics & Gynecology Physician	$0	$5.3M

Lane County Oregon — Billing Profile & Reimbursement Data

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Lane County Oregon — 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

Nearby Providers

Frequently Asked Questions

References