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.

Good Shepherd Health Care System (NPI 1336198159)

Good Shepherd Health Care System is a pediatrics physician provider located in Hermiston, Oregon. This profile covers 0 Medicare and 68 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	Good Shepherd Health Care System
Address	600 Nw 11th St Ste E33
City	Hermiston
State	OR
ZIP	97838
Taxonomy	Pediatrics Physician
NPI Enumerated	May 9, 2006

Payer Source	Total Paid
Medicaid	$4.5M
Medicare	$0

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

68 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	27,560	$60	$1.7M
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…	15,880	$70	$1.1M
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…	5,450	$80	$436.2K
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…	3,540	$70	$244.1K
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…	2,800	$90	$243.7K
98942	The provider applies manipulation to influence joint and neurophysiological function by a variety of techniques and modalities in five spinal regions.	5,560	$40	$222.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,270	$60	$81.5K
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,…	1,370	$40	$56.2K
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	3,180	$10	$44.5K
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…	2,770	$10	$38.7K

Showing 1–10 of 68

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

Good Shepherd Health Care System — 2 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

68 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…	99	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…	56	1,590	590	$50	$236.5K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	15	20	310	$140	$234.4K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	38	50	60	$80	$170.1K
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.	133	140	5,430	$10	$147.7K
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…	17	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…	26	180	220	$90	$124.6K
98941	The provider applies manipulation to influence joint and neurophysiological function by a variety of techniques and modalities in three to four spinal regions.	128	220	1,470	$30	$118.7K
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…	48	600	120	$80	$83.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	34	170	170	$90	$78.3K

Showing 1–10 of 68

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Good Shepherd Health Care System	OR	Critical Access Hospital	$0	$30.7M
Daniel Su	CA	Urology Physician	$395.2K	$18.9K
Wendy Roberts	CA	Dermatology Physician	$371.5K	$0
Manmohan Biring	OR	Pulmonary Disease Physician	$346.1K	$0
Donald Carlson	OR	Podiatrist	$158.3K	$163.5K
David Russo	OR	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$294.2K	$0
Fadi Akoum	OR	Nephrology Physician	$279.1K	$0
Jason Phillips	CA	Urology Physician	$250.4K	$0
Eugene Spear	NY	Cardiovascular Disease Physician	$245.5K	$0
Trey Rigert	OR	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$197.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Power House Residential Drug Treatment Center Inc	OR	Substance Abuse Rehabilitation Facility	$0	$7.9M
Oregon Pip Dental Group, PC	OR	Pediatric Dentistry	$0	$3.9M
Umatilla County Fire District Number 1	OR	Ambulance	$831.4K	$1.5M
Lifeways, Inc	OR	Psychiatric Residential Treatment Facility	$0	$1.3M
Praxis Health, PC	OR	Rural Health Clinic/Center	$0	$1.1M
David A Drotzmann Od PC	OR	Optometrist	$0	$1.1M
Julie Hereford	OR	Family Nurse Practitioner	$166.8K	$0
Eastern Oregon Regional Surgery	OR	Ambulatory Surgical Clinic/Center	$165.2K	$0
Rick Burrill	OR	Physical Therapist	$115.2K	$0
Walmart Inc.	OR	Community/Retail Pharmacy	$112.2K	$1.9K

Good Shepherd Health Care System — Billing Profile & Reimbursement Data

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Good Shepherd Health Care System — 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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