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 1609951649)

Field	Value
Entity Type	Organization
Organization	Providence Health & Services - Oregon
Address	870 S Front St
City	Central Point
State	OR
ZIP	97502
Taxonomy	Internal Medicine Physician
NPI Enumerated	October 26, 2006

Payer Source	Total Paid
Medicaid	$993.4K
Medicare	$0

Medicaid: Complete Services Breakdown

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

23 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…	12,020	$40	$480.8K
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…	12,500	$30	$425.1K
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…	780	$50	$41.1K
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…	400	$70	$26.3K
90832	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…	270	$40	$11.8K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	30	$90	$2.5K
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…	150	$10	$2K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	70	$20	$1.5K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	10	$60	$750
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	20	$30	$430

Showing 1–10 of 23

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 16 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

23 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	124	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…	137	1,590	590	$50	$236.5K
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…	127	600	120	$80	$83.3K
90832	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…	161	310	280	$70	$82K
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…	506	530	150	$110	$74.9K
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…	128	530	80	$120	$68.5K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	192	210	150	$60	$59.2K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	246	370	60	$110	$41.7K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	542	570	110	$50	$37.6K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	38	50	230	$30	$24.9K

Showing 1–10 of 23

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	$36.9M
Providence Health & Services - Oregon	OR	Clinical Pathology Physician	$0	$11.4M
Salem Pediatric Clinic	OR	Pediatrics Physician	$0	$9M
Providence Health & Services - Oregon	OR	Child & Adolescent Psychiatry Physician	$0	$8.7M
Providence Health & Services - Oregon	OR	Internal Medicine Physician	$0	$4.6M
Providence Health & Services - Oregon	OR	Internal Medicine Physician	$0	$3.8M
Providence Health & Services - Oregon	OR	Clinic/Center	$0	$3.6M
Providence Health & Services - Oregon	OR	Child & Adolescent Psychiatry Physician	$0	$3.1M
Providence Health & Services Oregon	OR	Internal Medicine Physician	$0	$3M
Providence Health & Services - Oregon	OR	Family Medicine Physician	$0	$2.7M

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
Elderly And Disabled Services	OR	Mental Illness Community Based Residential Treatment Facility	$0	$5.4M
Dunlap Physicians LLC	OR	Chiropractor	$0	$2.4M
Apria Healthcare LLC	OR	Durable Medical Equipment & Medical Supplies	$0	$1.5M
Columbacare Services	OR	Psychiatric Residential Treatment Facility	$0	$1.4M
Southern Oregon Chiropractic-central Point, LLC	OR	Chiropractor	$0	$1.3M
Rogue Valley Medical Transport	OR	Non-emergency Medical Transport (VAN)	$0	$1.1M
Costco Wholesale Corporation	OR	Community/Retail Pharmacy	$264.3K	$0
Jesse Hodson	OR	Family Nurse Practitioner	$57.8K	$0
Samuel Hirtle	OR	Family Medicine Physician	$57.7K	$0
Dean Brown	OR	Optometrist	$41.7K	$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