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.

Grande Ronde Hospital, Inc. (NPI 1467446195)

Key Findings

Field	Value
Entity Type	Organization
Organization	Grande Ronde Hospital, Inc.
Address	900 Sunset Dr
City	La Grande
State	OR
ZIP	97850
Taxonomy	Critical Access Hospital
NPI Enumerated	September 8, 2005

Payer Source	Total Paid
Medicaid	$20.1M
Medicare	$0

GRANDE RONDE HOSPITAL, INC. is effectively a Medicaid-centric provider: there is no Medicare billing on file and total Medicaid revenue on record is $20.1M, making Medicaid the sole material public-payer revenue source in this dataset for this entity. This concentration means analyses of payer mix and utilization should be interpreted in a Medicaid-only context rather than a dual-payer setting.

Revenue is highly concentrated in a small set of emergency department evaluation-and-management codes: the top three Medicaid codes (99284, 99283, 99285) account for 73.0% of the provider's total Medicaid revenue. Individually those codes are reported as $6.5M (33.1%) for 99284, $5.4M (27.5%) for 99283, and $2.4M (12.4%) for 99285, so a minority of service lines produce the majority of billing value.

The service mix is strongly ED- and acute-care oriented. The dominance of 9928x ED E/M codes (99284, 99283, 99285) plus frequent use of point-of-care diagnostics and procedures—93306 (echocardiography), 93005/93010 (ECG components), 71045 (chest x-ray), and intravenous medication administration codes such as 96374/96375—indicates this Critical Access Hospital functions as an emergency and hospital outpatient hub for diagnostic and infusion services.

State-level competitive standing on the highest-revenue ED codes is solid but not dominant: 99284 ranks #37 of 145 providers in-state (75th percentile) and is labeled as a typical, unremarkable volume; 99283 ranks #34 of 137 (76th percentile) and 99285 ranks #52 of 129 (60th percentile), both also described as typical, unremarkable volumes. These ranks suggest the hospital is a meaningful regional ED participant but not an outlier leader across the state for these services.

For office/outpatient E/M and procedure codes the hospital shows relatively high percentile placement on several measures: 99214 ranks #82 of 1503 providers (95th percentile), 99213 ranks #100 of 1591 (94th percentile), and 99205 ranks #13 of 187 (94th percentile); similarly, 96372 ranks #14 of 188 (93rd percentile). Although the dataset characterizes these as typical, unremarkable volumes, the high percentiles indicate stronger-than-average performance versus many in-state peers on selected outpatient E/M and injection/infusion services.

Despite some high percentile placements, the overarching statistical characterization across most listed codes is “typical, unremarkable volume for this code,” and there are no labels in the source indicating extreme outlier behavior. Payers and analysts should therefore treat the hospital as a consistently utilized Medicaid provider without unusual coding concentration beyond the expected ED-heavy profile.

The provider has long-standing enumeration: NPI was registered 2005-09-08 (~21 years ago), indicating operational longevity in the market. This tenure supports interpreting current billing patterns as stable service-line behavior rather than a short-lived anomaly.

For contracting and network planning, the data imply payers should anticipate ED-centered Medicaid utilization and allocate oversight and rate negotiations accordingly: the bulk of Medicaid dollars derive from a few ED E/M codes and related outpatient diagnostics/infusions, so efforts to manage utilization or design value arrangements should prioritize emergency and hospital outpatient pathways.

Medicaid: Complete Services Breakdown

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

152 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	24,350	$270	$6.5M
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.	28,320	$190	$5.4M
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.	6,230	$390	$2.4M
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…	18,690	$60	$1.1M
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…	16,560	$50	$861K
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.	9,260	$90	$842.4K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	1,310	$310	$403.1K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	3,140	$90	$282.1K
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…	2,090	$110	$223.1K
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…	2,160	$90	$189.9K

Showing 1–10 of 152

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

Grande Ronde Hospital, 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

152 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.	37	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.	52	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.	34	140	10,160	$130	$2.3M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	32	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.	32	60	3,620	$90	$623.7K
J0585	Injection, onabotulinumtoxina, 1 unit	18	20	470	$460	$398.7K
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…	79	80	1,420	$60	$368.8K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	47	60	460	$40	$327.4K
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.	11	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…	82	1,500	650	$70	$312.4K

Showing 1–10 of 152

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
William Pettit	OR	Ophthalmology Physician	$1.1M	$94K
David Mcnaul	MO	Diagnostic Radiology Physician	$269.4K	$0
Oliver Wisco	OR	MOHS-Micrographic Surgery Physician	$151.9K	$0
Steven Larsen	ID	Diagnostic Radiology Physician	$143.2K	$0
Paul Beck	CA	Surgery Physician	$117.2K	$12.7K
Kenneth Lightheart	UT	Cardiovascular Disease Physician	$122.5K	$0
Matthew Sigley	MO	Diagnostic Radiology Physician	$115.3K	$0
Matthew Allen	OR	Diagnostic Radiology Physician	$106.5K	$0
Jonathan Mcdougal	MA	Diagnostic Radiology Physician	$100.2K	$0
Gautham Kandukuri	OR	Vascular & Interventional Radiology Physician	$98.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Union County	OR	Case Management Agency	$0	$4.8M
Grande Ronde Recovery	OR	Addiction Psychiatry Physician	$0	$3.5M
Norco, Inc	OR	Durable Medical Equipment & Medical Supplies	$0	$1.5M
Assure Drug Detection LLC	OR	Clinical Medical Laboratory	$0	$1.3M
City Of La Grande	OR	Land Ambulance	$415.8K	$693.3K
Mountain Valley Therapy, Inc	OR	Physical Therapist	$0	$1.1M
Lincare Inc	OR	Durable Medical Equipment & Medical Supplies	$0	$1M
Center For Human Development, Inc	OR	Public Health or Welfare Agency	$65.3K	$559K
Daniel Kirkham	OR	Diagnostic Radiology Physician	$217.9K	$0
Travis Hampton	OR	Foot & Ankle Surgery Podiatrist	$198.5K	$0

Grande Ronde Hospital, Inc. — Billing Profile & Reimbursement Data

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Grande Ronde Hospital, Inc. — 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