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.

Providence Health & Services Oregon (NPI 1578014239)

Field	Value
Entity Type	Organization
Organization	Providence Health & Services Oregon
Address	10150 Se 32nd Ave
City	Milwaukie
State	OR
ZIP	97222
Taxonomy	Clinical Pathology Physician
NPI Enumerated	October 18, 2016

Payer Source	Total Paid
Medicaid	$5.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

6 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.	22,440	$100	$2.1M
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.	15,430	$120	$1.9M
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.	24,370	$60	$1.3M
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	13,070	$10	$78.4K
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…	70	$40	$2.7K
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…	10	$60	$740

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

Providence Health & Services Oregon — 0 of 6 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

6 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.	40	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.	32	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.	38	140	10,160	$130	$2.3M
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…	88	90	530	$50	$281.6K
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…	52	70	610	$60	$150.7K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	24	140	710	$10	$48.7K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Providence Health & Services Oregon, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Providence Health & Services - Oregon	OR	General Acute Care Hospital	$0	$49M
Providence Health & Services Oregon	OR	General Acute Care Hospital	$0	$20.5M
Charles Cannan	AZ	Cardiovascular Disease Physician	$114K	$0
Aly Rahimtoola	OR	Cardiovascular Disease Physician	$102.9K	$0
Kirsten Kinsman	OR	Gastroenterology Physician	$91.7K	$0
Kursteen Price	OR	Allergy & Immunology Physician	$90.3K	$0
Kevin Woolf	OR	Cardiovascular Disease Physician	$86.9K	$0
Alexander Morss	OR	Cardiovascular Disease Physician	$86.6K	$0
Geoffrey Wilson	OR	Cardiovascular Disease Physician	$80.5K	$0
Veselina Korcheva	OR	Dermatopathology (Pathology) Physician	$75.6K	$0

Nearby Providers

Other providers in the same ZIP code as Providence Health & Services Oregon, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eye Health Northwest, PC	OR	Ophthalmology Physician	$0	$15.7M
Sunnybrook Chiropractic Corp	OR	Chiropractor	$0	$2.1M
Scsm, Inc	OR	Chiropractor	$0	$1.6M
Precision Fit Dental Prosthetics LLC	OR	Denturist	$0	$1.2M
Clackamas Education Service District Ei Ecse	OR	Local Education Agency (LEA)	$0	$1.1M
Terry Isom	OR	Endodontics	$0	$1.1M
Clackamas County Fire District 1	OR	Land Ambulance	$155.6K	$601.7K
Joseph Simonett	OR	Ophthalmology Physician	$532.6K	$0
Jennifer Bray	OR	Family Nurse Practitioner	$105.2K	$0
Peter Taylor	OR	Psychiatry Physician	$101.9K	$0

Providence Health & Services Oregon — Billing Profile & Reimbursement Data

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Providence Health & Services Oregon — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References