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.

Saint Alphonsus Medical Center Baker City, Inc (NPI 1386636355)

Saint Alphonsus Medical Center Baker City, Inc is a critical access hospital provider located in Baker City, Oregon. This profile covers 0 Medicare and 54 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	Saint Alphonsus Medical Center Baker City, Inc
Address	3325 Pocahontas Rd
City	Baker City
State	OR
ZIP	97814
Taxonomy	Critical Access Hospital
NPI Enumerated	August 16, 2005

Payer Source	Total Paid
Medicaid	$4.3M
Medicare	$0

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

54 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.	9,530	$210	$2M
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.	8,540	$140	$1.2M
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.	2,540	$280	$714.9K
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.	270	$350	$92K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	540	$90	$51.1K
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.	7,760	$10	$46.6K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	490	$80	$40.7K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	400	$70	$28.4K
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…	6,980	$1	$27.9K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	7,910	$1	$23.7K

Showing 1–10 of 54

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

Saint Alphonsus Medical Center Baker City, Inc — 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

54 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.	81	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.	95	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.	71	140	10,160	$130	$2.3M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	39	40	3,200	$60	$1.5M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	51	60	3,620	$90	$623.7K
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.	13	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…	1,221	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.	77	80	1,210	$40	$294.3K
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.	64	140	5,430	$10	$147.7K
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	55	60	1,480	$40	$124.8K

Showing 1–10 of 54

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saint Alphonsus Medical Center- Ontario Inc	OR	General Acute Care Hospital	$0	$3.7M
Daniel Hanson	WA	Ophthalmology Physician	$454.6K	$0
Arthur Giebel	WA	Ophthalmology Physician	$257.8K	$0
Benjamin Perry	ID	Dermatology Physician	$227.3K	$0
Richard Thomas	ID	Dermatology Physician	$174.5K	$0
Alex Johnson	ID	Interventional Cardiology Physician	$91.8K	$0
Tara Evanger-dalke	WA	Optometrist	$42.2K	$0
Justin Gibb	ID	Certified Registered Nurse Anesthetist	$4.9K	$0
Spencer Stucki	OR	Certified Registered Nurse Anesthetist	$2.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
New Directions Northwest, Inc	OR	Community/Behavioral Health Agency	$0	$18.5M
St Lukes Clinic-treasure Valley LLC	OR	Rural Health Clinic/Center	$0	$2.1M
County Of Baker	OR	State or Local Public Health Clinic/Center	$8.7K	$235K
Brian Sanders	OR	Podiatrist	$175.8K	$0
Logan Frederickson	OR	Family Medicine Physician	$158.9K	$0
Blake Marlia	OR	Physical Therapist	$95.8K	$0
Jodi Flanagan	OR	Physical Therapist	$77.8K	$0
Robert Bachman	OR	Physical Therapist	$53.5K	$0
Kelli Wright	OR	Clinical Social Worker	$26.4K	$0
Kara Del Curto	OR	Psychiatric/Mental Health Clinical Nurse Specialist	$24.7K	$0

Saint Alphonsus Medical Center Baker City, Inc — Billing Profile & Reimbursement Data

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Saint Alphonsus Medical Center Baker City, Inc — 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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