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 Washington for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Washington 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. Washington (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.

Shoalwater Bay Indian Tribe (NPI 1003028952)

Field	Value
Entity Type	Organization
Organization	Shoalwater Bay Indian Tribe
Address	2373 Old Tokeland Rd
City	Tokeland
State	WA
ZIP	98590
Taxonomy	Dental Clinic/Center
NPI Enumerated	May 4, 2007

Payer Source	Total Paid
Medicaid	$3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	7,290	$400	$2.9M
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	680	$40	$24.5K
D0120	Periodic oral evaluation - established patient	870	$30	$24.4K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	1,410	$20	$22.6K
D2391	Resin‑based composite – one surface, posterior	360	$50	$16.8K
D2392	Post 2 surface resin‑based composite	170	$80	$13.4K
D0274	N/A	540	$10	$6.5K
D0140	Limited oral evaluation – problem focused	300	$20	$6.3K
D0220	Intraoral - periapical first radiographic image	560	$10	$4.5K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	70	$30	$2.1K

Showing 1–10 of 18

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Washington providers billing the same CPT/HCPCS codes.

Claims Volume vs. Washington Distribution

Shoalwater Bay Indian Tribe — 0 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. Washington median

18 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	267	650	4,110	$250	$4.9M
D2392	Post 2 surface resin‑based composite	403	540	990	$60	$188.6K
D0120	Periodic oral evaluation - established patient	425	920	690	$20	$131.3K
D2391	Resin‑based composite – one surface, posterior	300	480	670	$50	$119.5K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	326	390	640	$50	$98.8K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	308	730	730	$20	$98.5K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	310	660	620	$30	$76.1K
D0150	Comprehensive oral evaluation – new or established patient	588	710	600	$30	$65.7K
D4341	Periodontal scaling and root planing - four or more teeth per quadrant	225	230	680	$30	$58.9K
D0330	N/A	479	530	590	$30	$58.4K

Showing 1–10 of 18

Nearby Providers

Other providers in the same ZIP code as Shoalwater Bay Indian Tribe, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shoalwater Bay Tribe	WA	Primary Care Clinic/Center	$0	$4.1M

Shoalwater Bay Indian Tribe — Billing Profile & Reimbursement Data

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Shoalwater Bay Indian Tribe — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References