Lab
Kaiser Foundation Health Plan of the Northwest
Kaiser Foundation Health Plan of the Northwest was paid $61.71M by Medicaid between Jan 2018 and Dec 2024, across 185 billing codes. Its largest line is U0004, 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r — 7.0% of everything it billed.
33Billing provider infoKAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
PORTLAND, OR 97230
PORTLAND, OR 97230
33aNPI1245382753assigned 01/17/2007
33bProvider typeClinical Medical Laboratory
28Total paid$61.71M
24GClaims1,337,993
24DCodes billed185
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Clinical Medical Laboratory providers in Oregon
Rank by total paid#3 of 46
Median peer was paid$50K
This provider vs. median1,237×
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.
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 | 7,955 | $27K | |
| 2019 | 29,476 | $970K | |
| 2020 | 185,330 | $8.02M | |
| 2021 | 268,710 | $12.46M | |
| 2022 | 274,985 | $12.69M | |
| 2023 | 286,975 | $12.99M | |
| 2024incomplete | 284,562 | $14.56M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| U0004 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r | 7.0% | 58,497 | 53,933 | $4.29M |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | 6.8% | 40,540 | 38,908 | $4.22M |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 6.8% | 40,585 | 38,956 | $4.22M |
| 84443 | Thyroid stimulating hormone (TSH) | 4.9% | 77,251 | 74,703 | $3.01M |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 4.4% | 21,473 | 19,451 | $2.71M |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 4.0% | 15,543 | 11,911 | $2.45M |
| 80061 | Lipid panel | 3.4% | 63,250 | 61,799 | $2.10M |
| 83036 | Hemoglobin; glycosylated (A1C) | 3.3% | 88,087 | 85,504 | $2.04M |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | 3.0% | 30,760 | 29,998 | $1.87M |
| 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 not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed | 2.8% | 9,310 | 8,585 | $1.74M |
| 81420 | Fetal chromosomal aneuploidy genomic sequence analysis panel | 2.7% | 888 | 876 | $1.67M |
| 80053 | Comprehensive metabolic panel | 2.5% | 63,153 | 59,102 | $1.55M |
173 more codes
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | 2.2% | 20,507 | $1.38M |
| 86003 | 2.0% | 4,783 | $1.24M | |
| 82728 | 1.9% | 35,589 | $1.18M | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 1.8% | 59,955 | $1.10M |
| 86780 | 1.7% | 31,288 | $1.05M | |
| 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 throughput technologies as described by cms-2020-01-r | 1.5% | 13,400 | $955K |
| 88142 | 1.4% | 16,026 | $847K | |
| G0328 | Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous | 1.3% | 14,536 | $831K |
| 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | 1.3% | 6,244 | $828K |
| 85027 | 1.3% | 52,809 | $796K | |
| 82607 | 1.3% | 21,930 | $784K | |
| 87506 | 1.2% | 1,273 | $749K | |
| 81329 | 1.2% | 2,242 | $738K | |
| 80048 | Basic metabolic panel (calcium, ionized) | 1.2% | 36,670 | $715K |
| 87624 | Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types | 1.1% | 7,141 | $649K |
| 88307 | 1.0% | 1,067 | $642K | |
| 86803 | <1% | 15,241 | $537K | |
| 87507 | <1% | 588 | $529K | |
| 87505 | <1% | 1,626 | $483K | |
| 83550 | <1% | 21,575 | $451K | |
| 81513 | <1% | 1,274 | $440K | |
| 88342 | <1% | 2,120 | $429K | |
| 84702 | <1% | 11,878 | $419K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 5,271 | $412K |
| 88341 | <1% | 699 | $404K | |
| 87340 | <1% | 14,694 | $373K | |
| 87536 | <1% | 1,681 | $371K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 19,740 | $370K |
| 87653 | <1% | 4,957 | $355K | |
| 84403 | <1% | 5,671 | $350K | |
| 83540 | <1% | 20,749 | $331K | |
| 87529 | <1% | 2,196 | $327K | |
| U0005 | 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, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 | <1% | 8,510 | $298K |
| 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | <1% | 2,876 | $282K |
| 82042 | <1% | 14,085 | $246K | |
| 83516 | <1% | 8,659 | $243K | |
| 82670 | <1% | 3,338 | $215K | |
| 84460 | <1% | 16,586 | $208K | |
| 87186 | <1% | 10,077 | $206K | |
| 86140 | <1% | 15,926 | $198K | |
| 82565 | <1% | 16,116 | $196K | |
| 87077 | <1% | 9,210 | $184K | |
| 84439 | <1% | 8,512 | $184K | |
| 82746 | <1% | 5,116 | $179K | |
| 85610 | <1% | 20,145 | $172K | |
| 83970 | <1% | 1,908 | $167K | |
| 88312 | <1% | 696 | $165K | |
| 84153 | <1% | 3,537 | $152K | |
| 84146 | <1% | 3,237 | $149K | |
| 86704 | <1% | 4,938 | $146K | |
| 80076 | <1% | 7,240 | $143K | |
| 83001 | <1% | 3,200 | $141K | |
| 87081 | <1% | 8,805 | $139K | |
| 88304 | <1% | 2,107 | $138K | |
| 88141 | <1% | 2,020 | $135K | |
| 83735 | <1% | 8,372 | $127K | |
| 80069 | <1% | 6,710 | $127K | |
| 81001 | <1% | 15,481 | $111K | |
| 87070 | <1% | 5,200 | $105K | |
| 87481 | <1% | 1,191 | $103K | |
| 87661 | Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe | <1% | 1,196 | $103K |
| 86255 | <1% | 1,300 | $98K | |
| 87631 | <1% | 299 | $97K | |
| 87522 | Neg quan hep c or qual rna | <1% | 921 | $96K |
| 86787 | <1% | 3,101 | $95K | |
| 87517 | <1% | 857 | $92K | |
| 82627 | <1% | 1,680 | $92K | |
| 82784 | <1% | 2,978 | $90K | |
| 86706 | <1% | 3,382 | $90K | |
| 84480 | <1% | 2,571 | $90K | |
| 82274 | <1% | 2,705 | $85K | |
| 86038 | <1% | 2,892 | $85K | |
| 86160 | <1% | 1,670 | $83K | |
| 87808 | <1% | 2,226 | $83K | |
| 83993 | <1% | 1,528 | $82K | |
| 86200 | <1% | 2,583 | $81K | |
| 86762 | <1% | 2,361 | $80K | |
| 82533 | <1% | 1,879 | $73K | |
| 87088 | <1% | 3,736 | $72K | |
| G0103 | Prostate cancer screening; prostate specific antigen test (psa) | <1% | 1,094 | $70K |
| 84165 | <1% | 1,623 | $67K | |
| 86361 | <1% | 1,010 | $67K | |
| 84450 | <1% | 5,325 | $66K | |
| 82105 | <1% | 2,034 | $64K | |
| 82550 | <1% | 4,038 | $63K | |
| 82950 | <1% | 5,019 | $61K | |
| 82248 | <1% | 5,017 | $61K | |
| 81003 | <1% | 11,172 | $60K | |
| 84550 | <1% | 5,596 | $60K | |
| 88112 | <1% | 591 | $59K | |
| 88344 | <1% | 103 | $55K | |
| 86696 | <1% | 1,116 | $54K | |
| 83921 | <1% | 1,012 | $52K | |
| 84134 | <1% | 1,426 | $52K | |
| 86769 | <1% | 654 | $51K | |
| 83615 | <1% | 3,586 | $51K | |
| 83002 | <1% | 1,209 | $51K | |
| 86708 | <1% | 1,600 | $49K | |
| 84100 | <1% | 4,460 | $47K | |
| 86431 | <1% | 3,361 | $47K | |
| 82951 | <1% | 1,454 | $46K | |
| 80197 | <1% | 1,705 | $46K | |
| 88173 | <1% | 155 | $45K | |
| 83883 | <1% | 803 | $42K | |
| 82247 | <1% | 3,140 | $37K | |
| 86695 | <1% | 1,092 | $37K | |
| 86709 | <1% | 1,312 | $36K | |
| 84132 | <1% | 3,300 | $36K | |
| 87210 | <1% | 2,408 | $36K | |
| 82040 | <1% | 3,011 | $35K | |
| 86235 | <1% | 113 | $35K | |
| 87040 | <1% | 971 | $35K | |
| 85652 | <1% | 5,014 | $31K | |
| 86592 | <1% | 2,749 | $30K | |
| 84075 | <1% | 2,209 | $27K | |
| 86376 | <1% | 766 | $27K | |
| 83020 | <1% | 451 | $24K | |
| 82977 | <1% | 1,403 | $23K | |
| 87324 | <1% | 808 | $22K | |
| 87101 | <1% | 1,108 | $22K | |
| 82390 | <1% | 808 | $21K | |
| 82310 | <1% | 1,821 | $21K | |
| 87449 | <1% | 733 | $21K | |
| 86304 | <1% | 411 | $19K | |
| 87075 | <1% | 715 | $17K | |
| 85730 | <1% | 1,086 | $16K | |
| 85007 | <1% | 1,635 | $14K | |
| 85014 | <1% | 2,436 | $14K | |
| 85018 | <1% | 2,428 | $14K | |
| 87205 | <1% | 1,296 | $14K | |
| 82952 | <1% | 1,372 | $13K | |
| 86765 | <1% | 388 | $12K | |
| 84144 | <1% | 296 | $12K | |
| 86308 | <1% | 967 | $12K | |
| 82947 | <1% | 1,168 | $11K | |
| 86021 | <1% | 219 | $11K | |
| 80178 | <1% | 670 | $10K | |
| 86735 | <1% | 275 | $9K | |
| 82378 | <1% | 204 | $9K | |
| 86665 | <1% | 135 | $9K | |
| 85045 | <1% | 845 | $8K | |
| 86225 | <1% | 236 | $8K | |
| 86593 | <1% | 636 | $7K | |
| 83721 | <1% | 264 | $6K | |
| 81002 | <1% | 673 | $6K | |
| 84295 | <1% | 536 | $6K | |
| 81507 | <1% | 51 | $6K | |
| 83010 | <1% | 168 | $5K | |
| 80164 | <1% | 170 | $4K | |
| 84156 | <1% | 486 | $4K | |
| 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | <1% | 57 | $4K |
| 86317 | <1% | 97 | $4K | |
| 82340 | <1% | 226 | $3K | |
| 87102 | <1% | 131 | $3K | |
| 86664 | <1% | 65 | $2K | |
| 86147 | <1% | 31 | $2K | |
| 84478 | <1% | 159 | $2K | |
| 83021 | <1% | 57 | $2K | |
| 86663 | <1% | 55 | $2K | |
| 80175 | <1% | 69 | $2K | |
| 86705 | <1% | 58 | $2K | |
| 86146 | <1% | 19 | $1K | |
| 87107 | <1% | 41 | $1K | |
| 84520 | <1% | 110 | $1K | |
| 86334 | <1% | 13 | $969.64 | |
| 82465 | <1% | 46 | $507.05 | |
| 80177 | <1% | 13 | $394.28 | |
| 85379 | <1% | 12 | $307.14 | |
| 85008 | <1% | 26 | $182.40 | |
| 84300 | <1% | 13 | $156.00 | |
| 87338 | <1% | 16 | $85.60 | |
| 82570 | <1% | 100 | $67.14 | |
| 81050 | <1% | 13 | $46.86 |
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 officialMCCULLER, TAMMY (REVENUE CYCLE)
Parent organizationKAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
| Provider | Location | Paid |
|---|---|---|
| Kaiser Foundation Health Plan of the Northwest | Portland, OR | $116.27M |
| Kaiser Foundation Hospitals | Hillsboro, OR | $4.56M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.