Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

⚖️ Compare🖨️ Print Report

KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST

General Practice·PORTLAND, OR·NPI: 1184786527Share

Compared to General Practice Peers

Total spending distribution among 6 providers in this specialty

P25MedianP75P90

This provider's total spending of $116.3M is at the 50th percentile among 6 General Practice providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$116.3M

$116,269,773

Total Claims

1.3M

Beneficiaries

1.3M

1.0 claims/patient

Avg Cost/Claim

$87

Monthly Spending Trend

Yearly Spending

2018
$11.0M
+67%
2019
$18.3M
-49%
2020
$9.3M
+54%
2021
$14.3M
+28%
2022
$18.3M
+20%
2023
$22.0M
+6%
2024
$23.2M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 22% of total spending.

99213Top 1%

Office/outpatient visit, est. patient, low-mod complexity

$25.7M

162K claims · 22.1%

Your Cost: $157.97/claim|Median: $37.81
4.2× median
99214Top 1%

Office/outpatient visit, est. patient, mod-high complexity

$22.6M

105K claims · 19.4%

Your Cost: $215.04/claim|Median: $53.41
4.0× median
99284Top 10%

Emergency dept visit, high complexity

$8.1M

36K claims · 6.9%

Your Cost: $221.49/claim|Median: $69.51
3.2× median
99283Top 25%

Emergency dept visit, moderate complexity

$4.0M

30K claims · 3.4%

Your Cost: $131.99/claim|Median: $42.48
3.1× median
77067Top 1%

Screening mammography, bilateral, including CAD

$3.8M

13K claims · 3.2%

Your Cost: $295.43/claim|Median: $39.33
7.5× median
90471Top 5%

Immunization administration, 1 vaccine, percutaneous/ID/SC/IM

$2.0M

84K claims · 1.7%

Your Cost: $23.56/claim|Median: $9.80
2.4× median
71046Top 10%

Chest X-ray, 2 views

$2.0M

42K claims · 1.7%

Your Cost: $46.56/claim|Median: $8.92
5.2× median
74177Top 10%

CT abdomen and pelvis with contrast

$1.8M

4,166 claims · 1.5%

Your Cost: $423.47/claim|Median: $65.76
6.4× median
88305Top 5%

Surgical pathology, gross and microscopic examination

$1.4M

9,393 claims · 1.2%

Your Cost: $147.38/claim|Median: $35.80
4.1× median
99392Top 1%

Preventive medicine, established patient, age 1-4

$1.2M

5,001 claims · 1.1%

Your Cost: $245.94/claim|Median: $75.18
3.3× median
99391Top 1%

Preventive medicine, established patient, infant (under 1)

$1.2M

5,613 claims · 1.0%

Your Cost: $216.73/claim|Median: $69.35
3.1× median
90472Top 1%

Immunization administration, each additional vaccine

$1.1M

21K claims · 1.0%

Your Cost: $52.55/claim|Median: $11.79
4.5× median
87491Top 5%

Chlamydia detection, nucleic acid, amplified probe

$1.1M

15K claims · 0.9%

Your Cost: $73.34/claim|Median: $24.95
2.9× median
87591Top 5%

Neisseria gonorrhoeae detection, nucleic acid, amplified probe

$1.1M

15K claims · 0.9%

Your Cost: $73.34/claim|Median: $23.39
3.1× median
96413Top 5%

Chemotherapy administration, IV infusion, up to 1 hour

$1.1M

3,843 claims · 0.9%

Your Cost: $282.41/claim|Median: $75.28
3.8× median
93010Top 5%

Electrocardiogram, interpretation and report only

$1.1M

78K claims · 0.9%

Your Cost: $13.78/claim|Median: $5.60
2.5× median
91320Top 5%

$1.1M

6,157 claims · 0.9%

Your Cost: $170.67/claim|Median: $72.65
2.3× median
76816Top 1%

Ultrasound, pregnant uterus, follow-up

$1.0M

4,184 claims · 0.9%

Your Cost: $249.60/claim|Median: $58.55
4.3× median
99442Top 10%

Telephone E/M by physician, 11-20 minutes

$928K

12K claims · 0.8%

Your Cost: $77.45/claim|Median: $22.44
3.5× median
90832Top 10%

Psychotherapy, 30 minutes

$905K

7,695 claims · 0.8%

Your Cost: $117.65/claim|Median: $41.28
2.8× median
97110Top 5%

Therapeutic exercises, each 15 min

$863K

7,820 claims · 0.7%

Your Cost: $110.38/claim|Median: $24.49
4.5× median
99393Top 1%

Preventive medicine, established patient, age 5-11

$844K

3,593 claims · 0.7%

Your Cost: $234.89/claim|Median: $74.82
3.1× median
76705Top 5%

Ultrasound, abdominal, limited

$786K

5,658 claims · 0.7%

Your Cost: $138.95/claim|Median: $23.81
5.8× median
78815Top 1%

PET imaging for limited area

$767K

332 claims · 0.7%

Your Cost: $2,310.71/claim|Median: $325.10
7.1× median
93306Top 10%

Echocardiography, transthoracic, complete, with Doppler

$764K

3,335 claims · 0.7%

Your Cost: $228.94/claim|Median: $54.68
4.2× median
76805Top 1%

Ultrasound, pregnant uterus, complete, single fetus

$757K

2,358 claims · 0.7%

Your Cost: $321.23/claim|Median: $74.78
4.3× median
87880Top 5%

Streptococcus, Group A, rapid antigen detection

$699K

20K claims · 0.6%

Your Cost: $35.43/claim|Median: $11.48
3.1× median
76830Top 1%

Ultrasound, transvaginal

$692K

2,972 claims · 0.6%

Your Cost: $232.90/claim|Median: $57.47
4.1× median
76801Top 1%

Ultrasound, pregnant uterus, single fetus, first trimester

$689K

2,825 claims · 0.6%

Your Cost: $243.93/claim|Median: $58.16
4.2× median
99212Top 5%

Office/outpatient visit, low complexity

$671K

6,309 claims · 0.6%

Your Cost: $106.38/claim|Median: $25.06
4.2× median
80307Top 1%

Drug test, presumptive, by chemistry analyzers

$646K

4,626 claims · 0.6%

Your Cost: $139.75/claim|Median: $35.43
3.9× median
84443Top 5%

Thyroid stimulating hormone (TSH)

$609K

13K claims · 0.5%

Your Cost: $46.06/claim|Median: $9.87
4.7× median
85025Top 10%

Complete blood count (CBC) with differential, automated

$605K

32K claims · 0.5%

Your Cost: $18.68/claim|Median: $4.71
4.0× median
88142Top 5%

$579K

11K claims · 0.5%

Your Cost: $54.89/claim|Median: $14.75
3.7× median
80053Top 10%

Comprehensive metabolic panel

$561K

22K claims · 0.5%

Your Cost: $25.64/claim|Median: $7.24
3.5× median
J0585Top 25%

Injection, onabotulinumtoxinA, 1 unit

$555K

555 claims · 0.5%

Your Cost: $1,000.73/claim|Median: $470.36
2.1× median
90480Top 1%

$551K

7,074 claims · 0.5%

Your Cost: $77.84/claim|Median: $25.29
3.1× median
92004Top 25%

Ophthalmological exam, comprehensive, new patient

$528K

4,896 claims · 0.5%

Your Cost: $107.82/claim|Median: $59.72
1.8× median
99203Top 5%

Office/outpatient visit, new patient, low-mod complexity

$512K

2,831 claims · 0.4%

Your Cost: $181.02/claim|Median: $57.85
3.1× median
67028Top 10%

Intravitreal injection of a pharmacologic agent

$460K

2,046 claims · 0.4%

Your Cost: $224.81/claim|Median: $58.82
3.8× median
92015Top 10%

Determination of refractive state

$438K

17K claims · 0.4%

Your Cost: $26.03/claim|Median: $10.36
2.5× median
87389Top 5%

HIV-1 antigen with HIV-1 and HIV-2 antibodies

$434K

6,143 claims · 0.4%

Your Cost: $70.70/claim|Median: $18.03
3.9× median
81420Normal range

Fetal chromosomal aneuploidy genomic sequence analysis

$420K

1,507 claims · 0.4%

Your Cost: $278.50/claim|Median: $358.21
0.8× median
G0480Top 10%

Drug test, definitive, 1-7 drug classes

$407K

4,327 claims · 0.3%

Your Cost: $94.03/claim|Median: $37.56
2.5× median
83036Top 5%

Hemoglobin A1c (glycated hemoglobin)

$405K

16K claims · 0.3%

Your Cost: $25.57/claim|Median: $5.50
4.6× median
95800Top 10%

$402K

1,299 claims · 0.3%

Your Cost: $309.33/claim|Median: $86.65
3.6× median
73630Top 5%

X-ray, foot, complete, minimum 3 views

$396K

5,802 claims · 0.3%

Your Cost: $68.19/claim|Median: $12.06
5.7× median
99441Top 25%

Telephone E/M by physician, 5-10 min

$392K

8,723 claims · 0.3%

Your Cost: $44.92/claim|Median: $13.30
3.4× median
71250Top 5%

CT scan of chest without contrast

$388K

1,332 claims · 0.3%

Your Cost: $291.56/claim|Median: $39.11
7.5× median
99282Normal range

Emergency dept visit, low complexity

$385K

4,652 claims · 0.3%

Your Cost: $82.83/claim|Median: $37.72
2.2× median

Other Top Providers in Oregon

View all →

Trillium Family Services Inc.

Residential Treatment Facility Emotionally Distur

$154.5M

Byram Healthcare Centers, Inc.

Durable Medical Equipment & Medical Supplies

$123.9M

Similar Providers

Other top providers in General Practice

Fishing Point Health Care LLC

Portsmouth, VA

$169.8M

Danbury Hospital

Danbury, CT

$123.9M

← All providersAll providers in Oregon →How we detect fraud →