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.

Blue Mountain Hospital District (NPI 1356414395)

Blue Mountain Hospital District is a critical access hospital provider located in John Day, Oregon. This profile covers 0 Medicare and 40 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	Blue Mountain Hospital District
Address	170 Ford Rd
City	John Day
State	OR
ZIP	97845
Taxonomy	Critical Access Hospital
NPI Enumerated	November 16, 2006

Payer Source	Total Paid
Medicaid	$1.1M
Medicare	$0

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

40 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	6,200	$100	$638.6K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	950	$140	$135K
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.	730	$100	$75.1K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	980	$70	$72.7K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	11,760	$1	$23.5K
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.	4,570	$10	$22.8K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	5,080	$1	$20.3K
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…	300	$60	$18.6K
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…	90	$130	$12.2K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	70	$160	$10.3K

Showing 1–10 of 40

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

Blue Mountain Hospital District — 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

40 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	94	150	7,400	$170	$2.8M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	116	130	2,610	$200	$2.3M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	82	140	10,160	$130	$2.3M
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	87	90	2,490	$240	$2M
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	67	70	1,600	$170	$661.9K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	59	60	3,620	$90	$623.7K
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…	70	80	1,420	$60	$368.8K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	45	80	1,130	$90	$327.2K
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…	1,430	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.	145	290	770	$60	$252K

Showing 1–10 of 40

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Daniel Hanson	WA	Ophthalmology Physician	$454.6K	$0
Matthew Lilley	OR	Orthopaedic Surgery Physician	$186.8K	$0
Eddy Young	OR	Cardiovascular Disease Physician	$181.6K	$0
Oliver Wisco	OR	MOHS-Micrographic Surgery Physician	$151.9K	$0
Daniel Sedehi	OR	Cardiovascular Disease Physician	$149.7K	$0
Melissa Gunasekera	OR	Cardiovascular Disease Physician	$143.7K	$0
Brian Mott	OR	Cardiovascular Disease Physician	$128.6K	$50
Gary Foster	OR	Cardiovascular Disease Physician	$103.6K	$0
Shawna Clark	OR	Family Nurse Practitioner	$94.8K	$0
Samuel Christensen	OR	Medical Physician Assistant	$45.6K	$0

Blue Mountain Hospital District — Billing Profile & Reimbursement Data

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Blue Mountain Hospital District — 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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Frequently Asked Questions

References