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 1649344458)

Field	Value
Entity Type	Organization
Organization	Providence Health & Services Oregon
Address	727 S Wahanna Rd
City	Seaside
State	OR
ZIP	97138
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	November 20, 2006

Payer Source	Total Paid
Medicaid	$1.7M
Medicare	$0

Medicaid: Complete Services Breakdown

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

30 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…	12,470	$70	$847.8K
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…	10,380	$60	$653.6K
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…	960	$100	$97.8K
96152	N/A	220	$160	$35.1K
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…	680	$20	$13.6K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	510	$20	$11.8K
99443	N/A	100	$90	$8.5K
99442	N/A	40	$80	$3.1K
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…	40	$80	$2.9K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	100	$30	$2.8K

Showing 1–10 of 30

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 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

30 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…	120	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…	153	1,590	590	$50	$236.5K
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…	348	400	230	$90	$153.8K
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…	172	180	220	$90	$124.6K
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…	443	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…	272	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…	103	530	150	$110	$74.9K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	106	140	710	$10	$48.7K
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,…	525	570	110	$50	$37.6K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	135	150	60	$90	$33.7K

Showing 1–10 of 30

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	Critical Access Hospital	$0	$8M
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	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
Forest Drive Operations, LLC	OR	Assisted Living Facility	$0	$5.9M
Coda, Inc.	OR	Substance Use Disorder Rehabilitation Clinic/Center	$158K	$125.6K
Thrifty Payless Inc	OR	Community/Retail Pharmacy	$255.4K	$0
Zachary Caverley	OR	Physician Assistant	$101.2K	$0
Kyle Walker	OR	Internal Medicine Physician	$67.5K	$0
Gary Greenberg	OR	Cardiovascular Disease Physician	$58.7K	$0
Humza Maqbool	OR	Internal Medicine Physician	$57.6K	$0
Gregory Pigeon	OR	Certified Registered Nurse Anesthetist	$5.8K	$0
Amanda Washington	OR	Medical Physician Assistant	$4.6K	$0

Providence Health & Services Oregon — Billing Profile & Reimbursement Data

Sign up for Providence Health & Services Oregon — Billing Profile & Reimbursement Data policy alerts

Providence Health & Services Oregon — Billing Profile & Reimbursement Data

Sign up for Providence Health & Services Oregon — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References