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.

Rogue Valley Physicians (NPI 1699761932)

Rogue Valley Physicians is a family medicine physician provider located in Medford, Oregon. This profile covers 0 Medicare and 58 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Rogue Valley Physicians
Address	2900 Doctors Park Dr
City	Medford
State	OR
ZIP	97504
Taxonomy	Family Medicine Physician
NPI Enumerated	September 22, 2005

Payer Source	Total Paid
Medicaid	$3.6M
Medicare	$0

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

58 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…	20,080	$90	$1.8M
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…	20,850	$70	$1.4M
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…	1,760	$90	$151.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	8,670	$1	$17.3K
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…	810	$20	$16.1K
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…	170	$90	$15.5K
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…	150	$100	$14.9K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	2,430	$10	$14.6K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	1,240	$10	$11.1K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	980	$10	$9.8K

Showing 1–10 of 58

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

Rogue Valley Physicians — 1 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

58 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…	78	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…	77	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…	321	400	230	$90	$153.8K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	80	140	5,430	$10	$147.7K
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…	105	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…	105	180	220	$90	$124.6K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	49	100	1,090	$20	$107.8K
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…	48	310	280	$70	$82K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	91	160	2,690	$1	$81.3K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	71	110	770	$10	$79.7K

Showing 1–10 of 58

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Christopher Murphy	OR	Internal Medicine Physician	$308.8K	$0
Albert Newton	OR	Internal Medicine Physician	$169.9K	$0
Patrick Hungerford	OR	Endocrinology, Diabetes & Metabolism Physician	$130.1K	$0
Bryan Walls	OR	Family Medicine Physician	$114.7K	$0
Sharon Scelza	OR	Family Nurse Practitioner	$113.3K	$0
George Schultz	OR	Internal Medicine Physician	$108.7K	$0
Cindy Konecne	OR	Family Medicine Physician	$78.5K	$0
Michael Miller	OR	Clinical Social Worker	$12.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Asante	OR	General Acute Care Hospital	$0	$29.7M
Addictions Recovery Center, Inc.	OR	Substance Abuse Rehabilitation Facility	$0	$29.2M
Asante Physician Partners	OR	Family Medicine Physician	$0	$27.2M
Mercy Flights Incorporated	OR	Ambulance	$3.6M	$19.4M
Providence Health & Services - Oregon	OR	General Acute Care Hospital	$0	$20.9M
Crc Health Oregon, LLC	OR	Methadone Clinic	$193K	$13M
James Kolby Robinson, Dmd	OR	Pediatric Dentistry	$0	$11.6M
Valley Immediate Care, LLC	OR	Urgent Care Clinic/Center	$0	$9.4M
Lincare Inc	OR	Durable Medical Equipment & Medical Supplies	$0	$7.1M
Southern Oregon Pediatrics, LLP	OR	Pediatric Hospice and Palliative Medicine Physician	$0	$6.5M

Rogue Valley Physicians — Billing Profile & Reimbursement Data

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Rogue Valley Physicians — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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