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.

Oregon Health & Science University (NPI 1972688919)

Field	Value
Entity Type	Organization
Organization	Oregon Health & Science University
Address	707 Sw Gaines St
City	Portland
State	OR
ZIP	97239
Taxonomy	Clinic/Center
NPI Enumerated	October 26, 2006

Payer Source	Total Paid
Medicaid	$52.1M
Medicare	$0

Key Findings

OREGON HEALTH & SCIENCE UNIVERSITY reports no Medicare billing on file and is effectively a Medicaid-focused entity: total Medicaid revenue on record is $52.1M, with zero Medicare revenue reported. This makes the provider a single-payer (Medicaid) operation in the federal claims datasets available here, rather than a mixed Medicare/Medicaid billing profile.

Revenue is extremely concentrated in three high-value Medicaid codes: J7170 accounts for $44.3M (85.1% of this provider's total Medicaid revenue), J7192 accounts for $5M (9.7%), and S9435 accounts for $2.6M (4.9%), collectively representing 99.7% of the provider's Medicaid revenue. Those three codes therefore dominate the provider’s financial profile and billing activity on Medicaid.

The top codes indicate a specialty care and high-cost drug/medical-food operation: J7170 (injection, emicizumab-kxwh, 0.5 mg) and J7192 (Factor viii recombinant per i.u.) are high-cost biologic/hemophilia treatments, while S9435 (medical foods for inborn errors of metabolism) points to metabolic/nutrition services. The mix of expensive biologic injectables plus large volumes of medical foods suggests the provider operates specialized pharmacy, infusion, and metabolic-dietary service lines rather than general ambulatory primary care.

High average paid-per-claim values emphasize the drug-driven revenue model: J7170 shows 2.1K claims at $20800 avg paid/claim and J7192 shows 569 claims at $8851 avg paid/claim, indicating that a small number of claims for expensive biologics generate the lion’s share of revenue. In contrast, S9435 has 8.1K claims at $317 avg paid/claim, reflecting many low-dollar claims for medical foods that collectively contribute meaningfully to revenue.

Competitive standing within the state is effectively sole-provider for the top specialty drugs: J7170, J7192, and S9435 each rank #1 of 1 providers in-state (0th percentile; no state peer volume comparison available), which indicates this entity is the only in-state reporter for these codes in the dataset and therefore occupies a unique statewide position for these services. By contrast, S9430 (pharmacy compounding and dispensing services) generated $164.2K from 40 claims and ranks #2 of 2 providers in-state (0th percentile; typical, unremarkable volume), showing limited competition on that smaller revenue line.

Given that a single code, J7170, represents $44.3M (85.1% of Medicaid revenue), the provider’s Medicaid revenue stream is highly concentrated and therefore sensitive to changes in coverage, unit pricing, or utilization for that product. This concentration implies operational and reimbursement exposure tied closely to the market dynamics and payer policies affecting emicizumab (J7170).

Operational implications from the billing mix include likely investments in specialty pharmacy/infusion logistics, high-cost drug procurement, and coding/billing capacity to manage biologics claims: the observed claim counts and average paid-per-claim figures (e.g., $20800 and $8851) are consistent with a provider organized around specialty product administration and associated care coordination rather than volume-based primary care encounters. Those capabilities would be needed to support continued delivery and reimbursement of these high-cost items.

The provider has long tenure in the NPI registry (enumerated 2006-10-26, ~20 years ago), indicating an established presence in the market; combined with the sole-in-state reporting for major specialty codes, this suggests an entrenched specialty position in Oregon’s Medicaid landscape rather than a new or transient entrant.

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J7170	Injection, emicizumab-kxwh, 0.5 mg	2,130	$20,800	$44.3M
J7192	Factor viii (antihemophilic factor, recombinant) per i.u., not otherwise specified	570	$8,850	$5M
S9435	Medical foods for inborn errors of metabolism	8,130	$320	$2.6M
S9430	Pharmacy compounding and dispensing services	40	$4,110	$164.2K

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

Oregon Health & Science University — 0 of 4 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

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J7170	Injection, emicizumab-kxwh, 0.5 mg	1	10	2,130	$20,800	$44.3M
J7192	Factor viii (antihemophilic factor, recombinant) per i.u., not otherwise specified	1	10	570	$8,850	$5M
S9435	Medical foods for inborn errors of metabolism	1	10	8,130	$320	$2.6M
S9430	Pharmacy compounding and dispensing services	2	10	2,220	$110	$245.2K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Oregon Health & Science University	OR	General Acute Care Hospital	$0	$70.6M
Oregon Health & Science University	OR	Federally Qualified Health Center (FQHC)	$0	$9.7M
Oregon Health And Science University	OR	Dentist	$0	$1.4M
Andrew Henning	OR	Family Nurse Practitioner	$675.9K	$0
Sarah Gaines	RI	Emergency Medicine Physician	$0	$530.4K
Y Pritham Raj	OR	Internal Medicine Physician	$93.3K	$0
Matthew Slater	OR	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$54.6K	$0
Gregory Moneta	OR	Vascular Surgery Physician	$43.8K	$0
Kimberly Mauer	OR	Pain Medicine (Anesthesiology) Physician	$24K	$0
Michele Ferchau	OR	Family Nurse Practitioner	$22.6K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Professional Services	OR	General Practice Physician	$0	$55.6M
Shriners Hospitals For Children	OR	Children's Hospital	$0	$3.9M
Portland Dbt Institute, Inc.	OR	Cognitive & Behavioral Psychologist	$0	$3.7M
Rene Choi	OR	Ophthalmology Physician	$2.2M	$0
Housecall Providers, PC	OR	Family Medicine Physician	$0	$2M
Pediatric Orthotic And Prosthetic Services - Northwest, LLC	OR	Prosthetic/Orthotic Supplier	$0	$1.2M
Steven Bailey	OR	Retina Specialist (Ophthalmology) Physician	$1M	$0
Housecall Providers Services, LLC	OR	Community Based Hospice Care Agency	$0	$953.5K
Mind Solutions LLC	OR	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$952.2K
John Campbell	OR	Retina Specialist (Ophthalmology) Physician	$885.9K	$0

Oregon Health & Science University — Billing Profile & Reimbursement Data

Sign up for Oregon Health & Science University — Billing Profile & Reimbursement Data policy alerts

Oregon Health & Science University — Billing Profile & Reimbursement Data

Sign up for Oregon Health & Science University — Billing Profile & Reimbursement Data policy alerts

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