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.

Salem Clinic, PC (NPI 1912935594)

Key Findings

Field	Value
Entity Type	Organization
Organization	Salem Clinic, PC
Address	2020 Capitol St Ne
City	Salem
State	OR
ZIP	97303
Taxonomy	General Practice Physician
NPI Enumerated	June 30, 2006

Payer Source	Total Paid
Medicaid	$28.3M
Medicare	$0

SALEM CLINIC, PC operates effectively as a single‑payer Medicaid provider in Salem, OR: there is no Medicare billing on file and the clinic reports $28.3M in lifetime Medicaid revenue. This concentration makes Medicaid reimbursement policy and state program changes primary drivers of the practice’s financial performance.

Revenue is highly concentrated in a very small set of evaluation-and-management codes: the top 3 Medicaid codes account for 86.9% of total Medicaid revenue, led by 99213 ($14.2M, 51.7%), followed by 99214 ($8.2M, 29.9%) and 99203 ($1.5M, 5.3%). That level of concentration means reimbursement or utilization changes for those specific visit codes would have outsized impact on overall revenue.

The mix of dominant codes (99213, 99214, 99203) and claim volumes (203.2K claims for 99213; 67.4K claims for 99214; 7.5K claims for 99203) indicates a high-volume outpatient primary care/general practice operation focused on managing established patients and routine new patient visits. Code descriptors show most encounters are low-to-moderate complexity E/M visits, consistent with a general practice physician taxonomy and clinic workflows optimized for frequent face-to-face visits.

On competitive standing within Oregon for core primary care codes, the clinic ranks at the very top of peer distributions: 99213 ranks #2 of 1591 providers (100th percentile; extreme outlier) and 99214 ranks #17 of 1503 providers (99th percentile; extreme outlier), while 99203 ranks #17 of 596 providers (97th percentile; notably above typical). These rank/percentile positions characterize SALEM CLINIC as a dominant statewide provider for routine E/M office visits in Medicaid.

Ancillary services and point‑of‑care testing form meaningful secondary revenue streams: examples include 36415 (100K claims, $200K revenue; ranks #4 of 415, 99th percentile; notably above typical), 87635 (9.7K claims, $407.4K revenue; ranks #6 of 143, 96th percentile), and a suite of lab codes such as 83721 (16.1K claims, $64.3K revenue; ranks #1 of 15, 100th percentile; extreme outlier). High volumes for 96160 (28.4K claims, $113.6K revenue; ranks #1 of 259, 100th percentile; extreme outlier) and immunization codes (90471, 90686) suggest integrated screening and vaccine delivery workflows on site.

Operationally, the pattern of many short, low- to moderate-complexity visits plus high counts of blood draws, questionnaires, injections, and basic lab panels implies staffing and process designs focused on throughput and use of allied health staff. Presence of codes like 99211 (2.5K claims, $70.7K), 36415 (100K claims), and 96372 (8.3K claims, $74.7K revenue; ranks #2 of 188, 99th percentile; extreme outlier) points to reliance on nurses/medical assistants and standardized visit templates to sustain volume.

The practice’s NPI tenure (enumerated 2006-06-30 (~20 years ago)) together with the large Medicaid revenue base and repeated extreme-outlier ranks suggest an established, high-capacity community provider in the Salem market. That longevity supports institutional knowledge and likely stable patient panels concentrated in Medicaid.

From a risk/opportunity perspective, the clinic’s dependence on Medicaid ($28.3M and no Medicare revenue) and on a small set of E/M codes (top 3 = 86.9% of Medicaid revenue) creates both vulnerability and leverage: policy changes or documentation audits affecting 99213/99214/99203 could materially move revenue, while the clinic’s dominant statewide position on those codes could give it negotiating or operational scale advantages within Medicaid-focused value strategies.

Medicaid: Complete Services Breakdown

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

158 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	203,160	$70	$14.2M
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…	67,420	$120	$8.2M
99203	The provider sees a new 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 provider…	7,530	$190	$1.5M
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	6,320	$70	$455K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	3,990	$100	$415K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	9,700	$40	$407.4K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	10,780	$40	$388K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	2,060	$100	$214.7K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	99,990	$1	$200K
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…	1,710	$110	$195.4K

Showing 1–10 of 158

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

Salem Clinic, PC — 15 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

158 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	9	20	780	$30	$360.1K
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…	17	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…	2	1,590	590	$50	$236.5K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	14	70	350	$40	$189.7K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	14	70	350	$40	$189.3K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	73	90	320	$50	$187.6K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	25	50	60	$80	$170.1K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	25	70	690	$50	$169.3K
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…	211	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.	31	140	5,430	$10	$147.7K

Showing 1–10 of 158

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Martin Bassett	OR	Endocrinology, Diabetes & Metabolism Physician	$170.4K	$153.9K
Amit Bhandari	OR	Internal Medicine Physician	$154K	$14K
Brittany Vanraaphorst	FL	Family Medicine Physician	$157.4K	$0
Ryan Moore	OR	Diagnostic Radiology Physician	$126.5K	$0
Stacey Jesser	VA	Diagnostic Radiology Physician	$123.8K	$0
Jose Novoa	OR	Diagnostic Radiology Physician	$112.8K	$0
Stephen Carp	OR	Internal Medicine Physician	$104.5K	$0
Stephen Burrows	OR	Diagnostic Radiology Physician	$97.9K	$0
Travis Fromwiller	OR	Diagnostic Radiology Physician	$96.7K	$0
William Gillespie	OR	Internal Medicine Physician	$90.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
New Perspectives Center For Counseling & Therapy	OR	Mental Health Counselor	$0	$11.8M
Acorn Dentistry For Kids - Keizer, LLC	OR	Dental Clinic/Center	$0	$7.8M
Pelton Project, Inc.	OR	Psychiatric Residential Treatment Facility	$0	$4M
Keizer Rural Fire Protection Dist	OR	Land Ambulance	$285.6K	$2.3M
Renaissance Recovery Resources, Inc.	OR	Community/Behavioral Health Agency	$0	$2.3M
Dva Healthcare Renal Care Inc	OR	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.2M
Tess Gladstone	OR	Pediatric Dentistry	$0	$1.2M
Northwest Counseling And Wellness LLC	OR	Professional Counselor	$0	$977.8K
Robert Stevens	OR	Podiatrist	$66.6K	$182.4K
Joel James	OR	Dermatology Physician	$147.3K	$0

Salem Clinic, PC — Billing Profile & Reimbursement Data

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Salem Clinic, PC — 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