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.

Virginia Garcia Memorial Health Center (NPI 1679528012)

Field	Value
Entity Type	Organization
Organization	Virginia Garcia Memorial Health Center
Address	1151 N Adair St
City	Cornelius
State	OR
ZIP	97113
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	May 24, 2006

Payer Source	Total Paid
Medicaid	$4.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

145 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	25,420	$40	$991.4K
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…	11,780	$20	$223.8K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	13,050	$20	$195.7K
D0120	Periodic oral evaluation - established patient	6,590	$30	$184.4K
D1120	Prophylaxis–child	4,800	$40	$182.2K
D1351	Sealant - per tooth	7,240	$30	$180.9K
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…	1,690	$90	$155.7K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	3,300	$50	$151.6K
D2392	Post 2 surface resin‑based composite	2,010	$70	$132.7K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	1,630	$70	$120.7K

Showing 1–10 of 145

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

Virginia Garcia Memorial Health Center — 11 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

145 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	149	270	1,660	$90	$681K
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…	1,067	1,380	540	$140	$363.3K
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…	128	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…	61	1,590	590	$50	$236.5K
G9012	Other specified case management service not elsewhere classified	9	20	60	$330	$176.5K
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…	70	400	230	$90	$153.8K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	124	130	230	$110	$152K
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…	127	170	300	$80	$133.1K
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…	134	180	220	$90	$124.6K
99502	A home health provider, such as a registered nurse, visits a patient and her newborn at home to evaluate the newborn and provide newborn care education to the patient.	2	10	190	$400	$113.4K

Showing 1–10 of 145

Related Providers

Other providers that share a Tax Identification Number (TIN) with Virginia Garcia Memorial Health Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Virginia Garcia Memorial Health Center	OR	Federally Qualified Health Center (FQHC)	$0	$2.9M
Virginia Garcia Memorial Health Center	OR	Federally Qualified Health Center (FQHC)	$0	$1.9M
Virginia Garcia Memorial Health Center	OR	Federally Qualified Health Center (FQHC)	$0	$1.9M
Virginia Garcia Memorial Health Center	OR	Federally Qualified Health Center (FQHC)	$0	$1.2M
David Ko	CT	Family Medicine Physician	$49K	$0
Mary Denman	OR	Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician	$45.4K	$0

Nearby Providers

Other providers in the same ZIP code as Virginia Garcia Memorial Health Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Virginia Garcia Memorial Health Center	OR	Federally Qualified Health Center (FQHC)	$0	$2.3M
Walgreen Co	OR	Pharmacy	$81.4K	$40

Virginia Garcia Memorial Health Center — Billing Profile & Reimbursement Data

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Virginia Garcia Memorial Health Center — 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