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 1831289826)

Field	Value
Entity Type	Organization
Organization	Providence Health & Services Oregon
Address	6410 Ne Halsey St
City	Portland
State	OR
ZIP	97213
Taxonomy	Durable Medical Equipment & Medical Supplies
NPI Enumerated	October 13, 2006

Payer Source	Total Paid
Medicaid	$45.5M
Medicare	$0

Key Findings

This provider reports no Medicare billing on file and all recorded federal payer activity is through Medicaid, with total Medicaid revenue of $45.5M. In practical terms the organization is effectively a Medicaid-focused DME/MS supplier in Oregon rather than a mixed Medicare/Medicaid operator.

The top three Medicaid revenue drivers are concentrated: E1390 ($3.4M, 11.9%), E0601 ($2.2M, 7.7%), and E0603 ($2.2M, 7.6%), and the top 3 Medicaid codes by revenue account for 27.2% of this provider's total Medicaid revenue. This degree of concentration indicates a substantial share of Medicaid dollars tied to respiratory support and home medical equipment plus lactation support.

Code-level mix points to a core business oriented toward respiratory and sleep therapy supplies plus general DME and nutrition support: high-revenue codes include E1390 (oxygen concentrators), multiple positive airway pressure items (E0601, A7030, A7034, A7031, A7032, A7034), and enteral nutrition codes (B4035, B4149, B4160). The coexistence of high-volume CPAP interfaces, tubing (A4604), humidifiers (E0562), and hospital beds (E0260) shows the provider operates broad home-equipment distribution and consumables fulfillment at scale.

Several respiratory and PAP-related supply codes are statewide statistical outliers: A7030 and A7034 both rank #1 of 76 providers and are labeled as extreme outliers, far above typical state volume; A4604 and E0562 are also labeled extreme outliers with the provider ranked #1 of 80 and #1 of 77 respectively. These rankings indicate dominant in-state placement for mask/interface and tubing/heated-hose consumables in sleep/respiratory therapy relative to peers.

Other top codes show a mix of strong and typical statewide participation: E1390 is high-volume (33.8K claims) and ranks #4 of 70 providers (96th percentile), and E0601 and E0603 also rank in the mid-90s percentile for state volume (95th and 96th percentile). At the same time, high-cost items such as A9276 (CGM sensor) and A4239 (CGM supplies) appear with more modest or typical rank positions (#2 of 3 at 50th percentile for A9276; #3 of 11 at 80th percentile for A4239), suggesting the provider participates in diabetes technology but is not uniformly dominant across that product line.

Claim-volume metrics show operational scale in consumables distribution: for example E1390 has 33.8K claims, A4604 has 22K claims, A7034 has 13.8K claims, and A7030 has 12K claims. These multi-thousand-claim counts combined with significant revenues for individual codes signal a high-throughput DME supply chain and recurring consumable provisioning model rather than purely episodic, high-cost single-item sales.

Enteral feeding and home ventilation are meaningful but less dominant lines: B4035 generates $1.7M and ranks #3 of 16 providers (87th percentile) while home ventilator E0465 contributes $1.2M and ranks #3 of 7 (67th percentile). This pattern indicates the provider is an established supplier in enteral and ventilatory support within the state but not the top market leader for those specific categories.

The provider’s NPI was enumerated on 2006-10-13 (~20 years ago), signaling long-tenure presence in the market; combined with the concentration of high-volume DME and consumables billing, this longevity supports a mature operational footprint in Oregon’s Medicaid DME ecosystem.

Medicaid: Complete Services Breakdown

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

160 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	33,840	$100	$3.4M
E0601	Continuous positive airway pressure (CPAP) device	14,140	$160	$2.2M
E0603	Breast pump, electric (ac and/or dc), any type	11,180	$200	$2.2M
A9276	Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply	1,910	$950	$1.8M
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	6,060	$270	$1.7M
A4253	Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips	13,710	$110	$1.5M
L4361	Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf	5,790	$260	$1.5M
A7030	Full face mask used with positive airway pressure device, each	12,050	$120	$1.4M
E0465	Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)	1,880	$660	$1.2M
B4149	Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral…	1,220	$1,000	$1.2M

Showing 1–10 of 160

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 — 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

160 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A9276	Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply	2	10	1,910	$460	$5.5M
E2402	Negative pressure wound therapy electrical pump, stationary or portable	2	10	5,820	$640	$3.7M
A9277	Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system	2	10	4,260	$700	$3M
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	3	20	1,990	$210	$1.1M
B4161	Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding…	3	10	580	$480	$1.1M
B4149	Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral…	3	10	1,050	$440	$992.1K
E0465	Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)	3	10	1,710	$520	$915.3K
K0553	Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service	3	10	280	$140	$859.2K
A4239	Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service	3	10	350	$240	$690.5K
B4160	Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals,…	4	10	790	$150	$638.5K

Showing 1–10 of 160

Related Providers

Other providers that share a Tax Identification Number (TIN) with Providence Health & Services Oregon, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Providence Health & Services Oregon	OR	Home Infusion Therapy Pharmacy	$0	$9.8M
Cynthia Wallace	OR	Gerontology Nurse Practitioner	$23.2K	$0
Lena Hillenburg	OR	Hospice and Palliative Medicine (Internal Medicine) Physician	$19.3K	$0
Katherine Mayers	OR	Family Nurse Practitioner	$16.7K	$0
Lori Siegal	OR	Internal Medicine Physician	$16.4K	$0
Patricia Fogarty	OR	Hospice and Palliative Medicine (Internal Medicine) Physician	$16.2K	$0
Tula Top	WA	Hospice and Palliative Medicine (Internal Medicine) Physician	$15K	$0
Benjamin Ware	OR	Hospice and Palliative Medicine (Internal Medicine) Physician	$14.2K	$0
Maryam Saudagaran	OR	Gerontology Nurse Practitioner	$12.6K	$0
Elke Lowenkopf	OR	Hospice and Palliative Medicine (Internal Medicine) Physician	$11.5K	$0

Nearby Providers

Other providers in the same ZIP code as Providence Health & Services Oregon, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Providence Health & Services - Oregon	OR	General Acute Care Hospital	$0	$49M
Providence Health & Services - Oregon	OR	Clinical Pathology Physician	$0	$13.7M
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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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