Physician
Providence Health & Services - Oregon
Providence Health & Services - Oregon was paid $1.35M by Medicaid between Jan 2018 and Nov 2024, across 36 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 62% of everything it billed.
33Billing provider infoPROVIDENCE HEALTH & SERVICES - OREGON
GRESHAM, OR 97030
GRESHAM, OR 97030
33aNPI1053419218assigned 09/20/2006
33bProvider typeEndocrinology, Diabetes & Metabolism Physician
28Total paid$1.35M
24GClaims31,808
24DCodes billed36
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Endocrinology, Diabetes & Metabolism Physician providers in Oregon
Rank by total paid#1 of 7
Median peer was paid$191K
This provider vs. median7.0×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official ANDERSON, DONALD controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 2,528 | $161K | |
| 2019 | 3,210 | $191K | |
| 2020 | 2,519 | $150K | |
| 2021 | 4,311 | $120K | |
| 2022 | 4,813 | $191K | |
| 2023 | 7,619 | $276K | |
| 2024incomplete | 6,808 | $258K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 62% | 15,746 | 14,327 | $834K |
| 97803 | 20% | 3,321 | 3,017 | $272K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 6.4% | 1,696 | 1,602 | $86K |
| 96158 | 3.9% | 1,198 | 1,125 | $53K | |
| G0108 | Diabetes outpatient self-management training services, individual, per 30 minutes | 1.5% | 385 | 327 | $21K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 109 | 100 | $13K |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 1,064 | 1,033 | $12K |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | <1% | 98 | 91 | $9K |
| 99205 | Prolong outpt/office vis | <1% | 57 | 53 | $8K |
| 90686 | <1% | 652 | 624 | $7K | |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | <1% | 254 | 206 | $4K |
| 0031A | <1% | 154 | 140 | $4K |
24 more codes
| 97802 | <1% | 31 | $3K | |
| 98968 | <1% | 52 | $3K | |
| 96130 | <1% | 41 | $2K | |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 12 | $2K |
| 0012A | <1% | 51 | $2K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 18 | $2K |
| 36415 | Collection of venous blood by venipuncture | <1% | 871 | $1K |
| 0124A | <1% | 60 | $1K | |
| 0011A | <1% | 36 | $1K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 67 | $1K |
| 99443 | <1% | 32 | $1K | |
| 0004A | <1% | 50 | $880.00 | |
| 95251 | <1% | 27 | $713.42 | |
| 0001A | <1% | 12 | $440.00 | |
| 99442 | <1% | 15 | $234.39 | |
| 96127 | <1% | 46 | $187.16 | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 44 | $88.90 |
| G0008 | Administration of influenza virus vaccine | <1% | 34 | $4.13 |
| 90694 | <1% | 13 | $3.88 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 690 | $0.00 |
| H0049 | Alcohol and/or drug screening | 0% | 33 | $0.00 |
| 3074F | 0% | 2,544 | $0.00 | |
| 3079F | 0% | 42 | $0.00 | |
| 3078F | 0% | 2,253 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialANDERSON, DONALD (ASST SEC ENROLL)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.