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.

Kaiser Foundation Health Plan Of The Northwest (NPI 1689980740)

Field	Value
Entity Type	Organization
Organization	Kaiser Foundation Health Plan Of The Northwest
Address	500 Ne Multnomah St
City	Portland
State	OR
ZIP	97232
Taxonomy	General Practice Dentistry
NPI Enumerated	August 27, 2010

Payer Source	Total Paid
Medicaid	$6.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	16,730	$70	$1.1M
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	7,780	$130	$1M
D0274	N/A	9,640	$90	$896.4K
D0330	N/A	4,550	$170	$754.6K
D1120	Prophylaxis–child	5,320	$90	$489.7K
D0220	Intraoral - periapical first radiographic image	12,470	$40	$486.2K
D0120	Periodic oral evaluation - established patient	6,070	$80	$455.2K
D1330	N/A	4,680	$70	$341.7K
D0230	Intraoral - periapical each additional radiographic image	8,900	$40	$311.4K
D4910	Periodontal maintenance procedures	1,390	$220	$301.9K

Showing 1–10 of 22

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

Kaiser Foundation Health Plan Of The Northwest — 7 of 22 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

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D1120	Prophylaxis–child	30	480	350	$30	$55.5K
D2392	Post 2 surface resin‑based composite	229	360	260	$50	$47.6K
D0120	Periodic oral evaluation - established patient	32	610	460	$20	$40.9K
D0140	Limited oral evaluation – problem focused	49	560	240	$30	$37.9K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	8	500	280	$30	$30.5K
D9310	N/A	44	70	130	$60	$29.8K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	13	580	430	$10	$28.2K
D0150	Comprehensive oral evaluation – new or established patient	74	530	260	$20	$27.3K
D1351	Sealant - per tooth	200	260	360	$10	$25.7K
D2391	Resin‑based composite – one surface, posterior	230	310	160	$30	$25.2K

Showing 1–10 of 22

Nearby Providers

Other providers in the same ZIP code as Kaiser Foundation Health Plan Of The Northwest, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kaiser Foundation Health Plan Of The Northwest	OR	General Practice Physician	$0	$116.3M
Cascadia Health	OR	Multi-Specialty Clinic/Center	$0	$76.8M
Legacy Emanuel Hospital & Health Center	OR	General Acute Care Hospital	$0	$50.8M
Legacy Laboratory Services, LLC	OR	Clinical Medical Laboratory	$2.8M	$24.8M
The Oregon Clinic PC	OR	Specialist	$0	$7.4M
Laboratory Corporation Of America	OR	Clinical Medical Laboratory	$348.3K	$2.7M
Restore Therapy LLC	OR	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$2.9M
Cascade Pathology Services, Corp	OR	Anatomic Pathology & Clinical Pathology Physician	$0	$2.5M
Pacific Northwest Renal Services, L.L.C.	OR	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2M
Cascade Cytology Reference	OR	Anatomic Pathology & Clinical Pathology Physician	$0	$1.1M

Kaiser Foundation Health Plan Of The Northwest — Billing Profile & Reimbursement Data

Sign up for Kaiser Foundation Health Plan Of The Northwest — Billing Profile & Reimbursement Data policy alerts

Kaiser Foundation Health Plan Of The Northwest — Billing Profile & Reimbursement Data

Sign up for Kaiser Foundation Health Plan Of The Northwest — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References