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.

University Professional Services (NPI 1376709535)

Key Findings

Field	Value
Entity Type	Organization
Organization	University Professional Services
Address	3181 Sw Sam Jackson Park Rd
City	Portland
State	OR
ZIP	97239
Taxonomy	General Practice Physician
NPI Enumerated	August 6, 2008

Payer Source	Total Paid
Medicaid	$55.6M
Medicare	$0

This provider is effectively single‑payer on file: there is no Medicare billing on file while Medicaid revenue totals $55.6M, indicating the organization’s billed activity and payer exposure are dominated by Medicaid rather than a split Medicare/Medicaid mix. The absence of Medicare claims should be treated as a defining feature of its current payer profile when benchmarking against peers.

Revenue concentration is high in a handful of evaluation‑and‑management and emergency codes: the top three Medicaid codes (99214, 99213, 99285) account for 37.7% of total Medicaid revenue, with 99214 generating $7.8M (18.8%), 99213 generating $4.5M (10.8%), and 99285 generating $3.3M (8.0%). This concentration shows a reliance on high‑volume outpatient visits and emergency services for a large share of Medicaid receipts.

The code mix—high volumes of 99214, 99213, 99215, and a broad set of ED codes (99285/99284/99283), plus inpatient follow‑up (99233/99232) and critical care (99291)—indicates an integrated clinical operation that combines primary/ambulatory care, emergency department throughput, and inpatient services. Significant parallel volumes in diagnostic and specialty procedure codes (88305, 70553, 74177, , ) point to substantial in‑house pathology, imaging, cardiology, and ophthalmology capacity supporting that clinical footprint.

Statewide competitive standing for core ambulatory codes is exceptional: 99214 ranks #4 of 1503 providers in‑state (100th percentile; extreme outlier) and 99213 ranks #10 of 1591 (99th percentile; extreme outlier), while high‑intensity visit 99215 is #1 of 531 (100th percentile; extreme outlier). These rank/percentile signals identify the provider as a dominant or unusually large volume participant in outpatient E/M services within Oregon.

High‑acuity and hospital‑level care appear prominent as well: 99285 (ED high complexity) generates $3.3M and ranks #15 of 129 (89th percentile; typical), 99233 (high‑level subsequent inpatient care) generates $1.5M and ranks #4 of 91 (97th percentile; notably above), and 99291 (critical care) produces $1.3M and ranks #3 of 41 (95th percentile; typical). Together these data show meaningful Medicaid revenue from emergency, inpatient follow‑up, and critical care services, not just routine clinic visits.

Ancillary and specialty services materially contribute to Medicaid revenue and reflect in‑house service lines: pathology 88305 accounts for $1.8M (rank #2 of 90; 99th percentile; extreme outlier), MRI brain 70553 accounts for $902.8K (rank #1 of 30; 100th percentile; extreme outlier), and echocardiography 93306 accounts for $757.3K (rank #2 of 73; 99th percentile; extreme outlier). These patterns suggest vertically integrated diagnostic capacity that amplifies per‑patient revenue capture.

Non‑visit per‑diem and care‑management codes are notable revenue contributors: S0317 (disease management program; per diem) produces $2.4M and ranks #1 of 2 (100th percentile; typical), H2022 yields $889.5K (27 claims at $32,944 avg paid/claim), and G9006 (coordinated care fee, home monitoring) yields $879.1K. The presence of high average‑paid per‑claim items alongside large per‑claim volumes indicates that care management and wrap‑around payment streams are meaningful components of the Medicaid revenue mix.

The provider’s NPI has been enumerated since 2008‑08‑06 (~18 years ago), showing long tenure in the market. Coupled with the large Medicaid volumes and numerous extreme‑outlier rankings across codes, this tenure supports the interpretation of a mature, established operation with deep Medicaid relationships and substantial scale in the state.

Medicaid: Complete Services Breakdown

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

479 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…	122,160	$60	$7.8M
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…	97,900	$50	$4.5M
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.	29,640	$110	$3.3M
S0317	Disease management program; per diem	1,320	$1,800	$2.4M
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…	23,530	$90	$2.1M
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…	19,090	$100	$2M
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	41,800	$40	$1.8M
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.	21,780	$80	$1.8M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	24,540	$60	$1.5M
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…	20,460	$70	$1.4M

Showing 1–10 of 479

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

University Professional Services — 18 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

479 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G9006	Coordinated care fee, home monitoring	2	10	1,260	$3,990	$5M
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.	46	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.	15	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.	43	140	10,160	$130	$2.3M
S0317	Disease management program; per diem	1	10	670	$1,780	$1.2M
H2022	Community-based wrap-around services, per diem	7	10	170	$400	$977.5K
H0004	Behavioral health counseling and therapy, per 15 minutes	172	270	1,660	$90	$681K
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	2	10	1,480	$130	$443.3K
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	1	10	1,580	$300	$385.7K
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…	44	80	1,420	$60	$368.8K

Showing 1–10 of 479

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Legacy Clinics LLC	OR	Clinic/Center	$35.6K	$48.7M
University Professional Services	OR	Pharmacy	$0	$8.1M
Rene Choi	OR	Ophthalmology Physician	$2.2M	$0
Dong-wouk Park	WA	Retina Specialist (Ophthalmology) Physician	$1.9M	$0
Scott Mcclintic	OR	Ophthalmology Physician	$1.7M	$0
Ngoc-lam Nguyen	FL	Orthopaedic Surgery of the Spine Physician	$1.3M	$0
Steven Bailey	OR	Retina Specialist (Ophthalmology) Physician	$1M	$0
University Professional Services	OR	General Practice Physician	$0	$988.2K
John Campbell	OR	Retina Specialist (Ophthalmology) Physician	$885.9K	$0
Andrew Henning	OR	Family Nurse Practitioner	$675.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Oregon Health & Science University	OR	General Acute Care Hospital	$0	$70.6M
Oregon Health & Science University	OR	Clinic/Center	$0	$52.1M
Shriners Hospitals For Children	OR	Children's Hospital	$0	$3.9M
Portland Dbt Institute, Inc.	OR	Cognitive & Behavioral Psychologist	$0	$3.7M
Housecall Providers, PC	OR	Family Medicine Physician	$0	$2M
Pediatric Orthotic And Prosthetic Services - Northwest, LLC	OR	Prosthetic/Orthotic Supplier	$0	$1.2M
Housecall Providers Services, LLC	OR	Community Based Hospice Care Agency	$0	$953.5K
Mind Solutions LLC	OR	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$952.2K
Merina Thomas	OR	Retina Specialist (Ophthalmology) Physician	$640.5K	$0
Nieraj Jain	OR	Ophthalmology Physician	$387.4K	$0

University Professional Services — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References