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.

Oregon Pediatrics Ne Portland PC (NPI 1366488090)

Oregon Pediatrics Ne Portland PC is a pediatrics physician provider located in Portland, Oregon. This profile covers 0 Medicare and 44 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	Oregon Pediatrics Ne Portland PC
Address	5050 Ne Hoyt St
City	Portland
State	OR
ZIP	97213
Taxonomy	Pediatrics Physician
NPI Enumerated	June 21, 2006

Payer Source	Total Paid
Medicaid	$2.2M
Medicare	$0

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

44 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…	7,720	$90	$687.2K
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…	10,020	$60	$601.2K
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…	2,150	$130	$270.3K
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…	2,060	$120	$241.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,170	$130	$147.8K
96160	The provider administers a questionnaire aimed at helping to identify a specific health risk to a patient, analyzes the results, assigns a score, and documents the findings. Use this code for each…	4,640	$10	$51K
99072	The provider uses items, supplies materials, or requires clinical staff time in excess of what is normally used or provided for an office visit or other nonfacility encounter. These additional items…	12,140	$1	$36.4K
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…	1,520	$20	$27.4K
D0191	N/A	1,910	$10	$24.8K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	2,200	$10	$19.8K

Showing 1–10 of 44

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

Oregon Pediatrics Ne Portland PC — 1 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

44 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…	202	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…	159	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…	33	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…	36	180	220	$90	$124.6K
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…	305	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.	38	170	170	$90	$78.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	111	150	60	$90	$33.7K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	302	580	430	$10	$28.2K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	25	90	170	$20	$22.6K
0002A	N/A	127	130	70	$30	$20.9K

Showing 1–10 of 44

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
Providence Health & Services - Oregon	OR	Child & Adolescent Psychiatry Physician	$0	$8.7M
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
Providence Health & Services - Oregon	OR	Internal Medicine Physician	$0	$3.8M
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 — Billing Profile & Reimbursement Data

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Oregon Pediatrics Ne Portland PC — 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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References