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.

Bay Clinic (NPI 1538174958)

Bay Clinic is a specialist provider located in Coos Bay, Oregon. This profile covers 0 Medicare and 100 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	Bay Clinic
Address	1750 Thompson Road
City	Coos Bay
State	OR
ZIP	97420
Taxonomy	Specialist
NPI Enumerated	July 31, 2006

Payer Source	Total Paid
Medicaid	$2M
Medicare	$0

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

100 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…	24,740	$20	$519.4K
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…	27,730	$10	$332.8K
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…	9,370	$20	$150K
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…	4,840	$20	$72.6K
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…	3,670	$20	$69.7K
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…	4,770	$10	$66.8K
95024	The provider introduces allergenic extracts into the skin to determine if the patient has an immediate allergic response, interprets the results and writes a report specifying the number of tests.	430	$150	$62.9K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	500	$120	$58.9K
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…	330	$140	$46.3K
95117	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives 2 or more injections at a single visit.	5,010	$10	$45.1K

Showing 1–10 of 100

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

Bay Clinic — 5 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

100 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	997	1,380	540	$140	$363.3K
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	12	20	780	$30	$360.1K
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…	61	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…	55	1,590	590	$50	$236.5K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	32	70	350	$40	$189.7K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	32	70	350	$40	$189.3K
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…	45	90	320	$50	$187.6K
90834	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…	369	400	230	$90	$153.8K
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.	77	140	5,430	$10	$147.7K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	44	100	370	$30	$138.2K

Showing 1–10 of 100

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Satish Bankuru	OR	Internal Medicine Physician	$149.3K	$17.5K
Davina Bledsoe	OR	Nurse Practitioner	$123.4K	$5.8K
Rolando Gonzalez	FL	Internal Medicine Physician	$126.2K	$0
Wendy Haack	OR	Internal Medicine Physician	$88.8K	$10.5K
Peter Lund	OR	Specialist	$32.8K	$14.1K
Yvonne Fenrich	OR	Advanced Practice Midwife	$24.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
North Bend Medical Center Inc	OR	Multi-Specialty Clinic/Center	$0	$12.4M
Bay Cities Ambulance	OR	Land Ambulance	$1.7M	$9.5M
Bay Area Hospital District	OR	General Acute Care Hospital	$0	$8.7M
Coos County Oregon	OR	Clinic/Center	$0	$8.5M
Cep America LLC	OR	Emergency Medicine Physician	$0	$5.7M
Lincare Inc.	OR	Durable Medical Equipment & Medical Supplies	$0	$3.4M
Coos County Oregon	OR	Public Health or Welfare Agency	$15.8K	$3.2M
Coquille Indian Tribe	OR	Clinic/Center	$0	$2.1M
Nbmc Day Surgery Inc	OR	Ambulatory Surgical Clinic/Center	$1.1M	$830.1K
Coastal Center, LLC.	OR	Mental Health Counselor	$0	$1.7M

Bay Clinic — Billing Profile & Reimbursement Data

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Bay Clinic — 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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