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 1740732650)

Providence Health & Services - Oregon is a clinical pathology physician provider located in Portland, Oregon. This profile covers 0 Medicare and 29 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	Providence Health & Services - Oregon
Address	4805 Ne Glisan St
City	Portland
State	OR
ZIP	97213
Taxonomy	Clinical Pathology Physician
NPI Enumerated	October 26, 2016

Payer Source	Total Paid
Medicaid	$13.7M
Medicare	$0

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

29 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	58,950	$120	$6.8M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	37,960	$90	$3.5M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	28,670	$60	$1.6M
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	16,500	$40	$626.9K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	9,660	$40	$396K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	63,680	$10	$382.1K
11043	The provider uses surgical instruments to remove the dead tissue in muscle and/or fascia, including any debridement of the epidermis, dermis, and subcutaneous tissue, for the first or only 20 cm2 or…	1,120	$90	$100.6K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	2,180	$50	$98.1K
H0005	Alcohol and/or drug services; group counseling by a clinician	910	$40	$40.1K
88141	The physician analyzes and interprets a cervical or vaginal cytopathology specimen, using any reporting system, such as Bethesda or non–Bethesda. This code is for the professional interpretation by…	1,640	$20	$34.4K

Showing 1–10 of 29

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 — 4 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

29 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	19	150	7,400	$170	$2.8M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	4	130	2,610	$200	$2.3M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	33	140	10,160	$130	$2.3M
H0005	Alcohol and/or drug services; group counseling by a clinician	123	180	3,250	$40	$783.8K
H0004	Behavioral health counseling and therapy, per 15 minutes	192	270	1,660	$90	$681K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	29	40	380	$130	$326.9K
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…	841	1,500	650	$70	$312.4K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	9	90	530	$50	$281.6K
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…	728	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…	363	400	230	$90	$153.8K

Showing 1–10 of 29

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Providence Health & Services - Oregon	OR	General Acute Care Hospital	$0	$49M
Providence Health & Services - Oregon	OR	General Acute Care Hospital	$0	$20.1M
Providence Health & Services - Oregon	OR	Clinical Pathology Physician	$0	$3.8M
Julia Obadiah	OR	MOHS-Micrographic Surgery Physician	$444.5K	$0
Anna Bar	OR	MOHS-Micrographic Surgery Physician	$151.3K	$0
Zachary Pena	OR	Dermatology Physician	$132.7K	$0
Pratik Bhattacharya	MI	Neurology Physician	$115.9K	$0
Charles Cannan	AZ	Cardiovascular Disease Physician	$114K	$0
Jennifer Bray	OR	Family Nurse Practitioner	$105.2K	$0
Aly Rahimtoola	OR	Cardiovascular Disease Physician	$102.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Providence Health & Services Oregon	OR	Durable Medical Equipment & Medical Supplies	$0	$45.5M
Providence Health & Services Oregon	OR	Home Infusion Therapy Pharmacy	$0	$9.8M
Providence Health & Services - Oregon	OR	Child & Adolescent Psychiatry Physician	$0	$8.7M
Radiology Specialists Of The Northwest, PC	OR	Diagnostic Radiology Physician	$0	$5.7M
Laboratory Corporation Of America	OR	Clinical Medical Laboratory	$1.4M	$3.2M
Providence Health & Services - Oregon	OR	Internal Medicine Physician	$0	$3.8M
Uptown Providers Inc	OR	Urgent Care Clinic/Center	$0	$2.8M
Credena Health LLC	OR	Specialty Pharmacy	$0	$2.5M
Oregon Pediatrics Ne Portland PC	OR	Pediatrics Physician	$0	$2.2M
Behavioral Learning Network - Oregon LLC	OR	Behavior Analyst	$0	$1.8M

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

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