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.

Portland Adventist Medical Center (NPI 1801887658)

Key Findings

Field	Value
Entity Type	Organization
Organization	Portland Adventist Medical Center
Address	10123 Se Market St
City	Portland
State	OR
ZIP	97216
Taxonomy	General Acute Care Hospital
NPI Enumerated	November 1, 2005

Payer Source	Total Paid
Medicaid	$41.8M
Medicare	$0

This provider is effectively a Medicaid-only billing entity in the available dataset: Total Medicaid revenue is $41.8M and there is no Medicare billing on file. That concentration means Medicaid payment policy and enrollment will largely determine the financial footprint visible in claims data for this organization.

Medicaid revenue is highly concentrated in emergency department evaluation-and-management codes: the top three Medicaid codes (99285, 99284, 99283) account for 77.9% of the provider's total Medicaid revenue. Those three codes individually contribute $13.8M (33.4%), $11.1M (27.0%), and $7.2M (17.5%) respectively, signaling that high-acuity and moderate- to low-acuity ED visits drive the bulk of reported revenue.

The code mix indicates the facility operates as an acute-care hospital with a heavy emergency-department orientation: large claim volumes and dollars are reported for ED E/M codes 99285 (40.8K claims, $337 avg paid/claim), 99284 (43.7K claims, $254 avg paid/claim) and 99283 (40.1K claims, $179 avg paid/claim). Outpatient clinic activity (G0463: 46.9K claims, $83 avg paid/claim, $3.9M revenue, 9.5%) and imaging (71045: 20.5K claims) further support a high-throughput hospital outpatient/ED operating model.

Competitive standing on core ED codes is relatively strong within Oregon: 99285 ranks #11 of 129 providers in-state (92th percentile; typical, unremarkable volume for this code), 99284 ranks #14 of 145 (91th percentile; typical, unremarkable volume for this code), and 99283 ranks #19 of 137 (87th percentile; typical, unremarkable volume for this code). In plain terms, the provider sits in the upper percentiles for ED volume statewide but the dataset flags these volumes as typical rather than as statistical outliers.

Beyond ED services, the provider reports substantial ancillary and procedural activity consistent with an acute hospital: imaging and diagnostics such as 71045 (20.5K claims, $901.6K revenue) and 70450 (2.6K claims, $202.6K revenue); high-volume lab panels 80053 (91.2K claims, $91.2K revenue) and 85025 (90.8K claims, $90.8K revenue) which are both described as notably above typical state volume; and infusion/IV codes like 96374 (7.6K claims, $847.3K revenue). These codes indicate breadth of in-hospital services from laboratory throughput to infusion and procedural care.

There are a few code-level outliers that stand apart from the ED concentration: 29581 (1.6K claims, $127.5K revenue) ranks #1 of 9 providers in-state (100th percentile; notably above typical state volume), suggesting this provider is a leading source of multilayer compression therapy in Oregon. Similarly, 80053 and 85025 are marked as notably above typical state volume, pointing to unusually high facility-level lab panel volumes relative to peers.

The provider has an established operational tenure in the NPI registry (NPI enumerated: 2005-11-01 (~21 years ago)), which supports interpreting these patterns as stable service lines rather than short-term anomalies. Combined with the heavy Medicaid concentration ($41.8M) and no Medicare billing on file, the practice profile appears entrenched in Medicaid-funded acute and ED care.

From a revenue-risk and strategic perspective, reliance on ED E/M codes for 77.9% of Medicaid revenue creates exposure: changes in ED utilization patterns, state Medicaid reimbursement, or site-of-service payment policy could materially affect reported revenue. This concentration also means competitive moves by nearby hospitals or payers that shift ED volume could disproportionately impact this provider's Medicaid revenue base.

Medicaid: Complete Services Breakdown

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

200 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.	40,820	$340	$13.8M
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.	43,750	$250	$11.1M
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.	40,110	$180	$7.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	46,910	$80	$3.9M
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	20,490	$40	$901.6K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	7,630	$110	$847.3K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	6,010	$100	$595.1K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	10,840	$40	$390.3K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	910	$330	$302.5K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	5,370	$50	$284.4K

Showing 1–10 of 200

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

Portland Adventist Medical Center — 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

200 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.	14	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.	11	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.	19	140	10,160	$130	$2.3M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	6	40	3,200	$60	$1.5M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	24	60	3,620	$90	$623.7K
Q5103	Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg	6	10	100	$1,160	$435.3K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	9	60	420	$60	$405.1K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	12	60	460	$40	$327.4K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	19	80	1,130	$90	$327.2K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	24	40	310	$420	$325.7K

Showing 1–10 of 200

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Portland Adventist Medical Center	OR	Family Medicine Physician	$0	$12.8M
Portland Adventist Medical Center	OR	Family Medicine Physician	$0	$5.8M
Portland Adventist Medical Center	OR	Emergency Medical Services (Emergency Medicine) Physician	$0	$5M
Eugene Spear	NY	Cardiovascular Disease Physician	$245.5K	$0
Daniel Feldman	OR	Interventional Cardiology Physician	$60.7K	$0
Gary Greenberg	OR	Cardiovascular Disease Physician	$58.7K	$0
Michael Gardner	OR	Cardiovascular Disease Physician	$56.4K	$0
Joshua Roark	OR	Interventional Cardiology Physician	$48.3K	$0
Erin Boehm	OR	Cardiovascular Disease Physician	$39.9K	$0
Gail Jones	OR	Cardiovascular Disease Physician	$39.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Byram Healthcare Centers, Inc.	OR	Durable Medical Equipment & Medical Supplies	$0	$123.8M
Fora Health Inc.	OR	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$54.4M
Cep America LLC	OR	Emergency Medicine Physician	$0	$2.9M
Diagnostic Radiologists PC	OR	Diagnostic Radiology Physician	$0	$2.7M
Jonathan Yoken	OR	Retina Specialist (Ophthalmology) Physician	$1.5M	$0
Rsa - Portland, LLC	OR	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.3M
Brian Chan-kai	OR	Retina Specialist (Ophthalmology) Physician	$1.3M	$0
Anchor Within Counseling	OR	Community/Behavioral Health Agency	$0	$951.7K
Jonathan Kemp	OR	Ophthalmology Physician	$221.9K	$0
Shane Kim	OR	Ophthalmology Physician	$191.1K	$0

Portland Adventist Medical Center — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References