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

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

Fallon Tribal Health Center (NPI 1023057478)

Field	Value
Entity Type	Organization
Organization	Fallon Tribal Health Center
Address	1001 Rio Vista Dr
City	Fallon
State	NV
ZIP	89406
Taxonomy	Clinic/Center
NPI Enumerated	June 4, 2006

Payer Source	Total Paid
Medicaid	$24.8M
Medicare	$0

Key Findings

This provider is effectively single‑payer at the federal program level: there is no Medicare billing on file while Medicaid accounts for the provider's entire recorded federal revenue at $24.8M. The absence of Medicare activity combined with material Medicaid revenue indicates the organization operates primarily within the Medicaid delivery system rather than serving a dual Medicare/Medicaid mix.

Revenue is extremely concentrated into the top clinic encounter code: the precomputed top‑3 Medicaid codes together account for 100.0% of this provider's total Medicaid revenue, and T1015 generates $24.8M (100.0% of the provider's Medicaid revenue). This concentration implies financial dependence on all‑inclusive clinic/encounter reimbursements rather than fee‑for‑service line items.

The dominant revenue driver is T1015 (Clinic visit/encounter, all‑inclusive), which by description covers comprehensive encounter-level payments; this suggests FALLON TRIBAL HEALTH CENTER bills primarily through bundled or all‑inclusive clinic encounters rather than relying on discrete procedure-level reimbursements. The presence of a preventive/adolescent visit code (99394) in the top list — albeit accounting for only $9.8K — indicates the clinic also provides routine preventive services alongside its encounter-based billing model.

Competitive standing within Nevada is strong for the encounter code: T1015 ranks #2 of 58 providers in-state and sits in the 98th percentile, described in the source as notably above typical state volume for this code. That ranking marks the center as a major in‑state provider for all‑inclusive clinic encounters, even though it does not bill Medicare.

Multiple commonly billed service codes show nonzero claim counts but $0 avg paid/claim and $0 revenue in the Medicaid file (examples include D0220, 99000, 83036, and many dental and lab codes). This pattern is consistent with those services being recorded on claims but reimbursed under a bundled encounter payment (T1015) or otherwise not separately paid in the dataset; it highlights an operational billing pattern where encounter payments likely subsume many ancillary services.

The overall code mix shows a broad scope of primary care and ancillary services: top claims include dental procedures (D1330, D0230, D1110, D1206), routine E/M visits (99211, 99213, 99214, 99215), lab/COVID testing codes (87428, 87635, 87426) and immunization code 90471. Even where these codes register only modest or zero recorded Medicaid revenue, their claim frequencies indicate on‑site dental, laboratory, diagnostic, and preventive capabilities supporting a comprehensive community clinic model.

Operational longevity is notable: the NPI was enumerated on 2006-06-04 (~20 years ago), indicating a long‑standing presence in the community and likely established relationships with state Medicaid programs and local patients. That tenure, combined with a high in‑state rank on the primary clinic encounter code, supports the view of a stable, locally significant clinic operation.

Beyond the dominant T1015 role, the remaining top codes show limited revenue impact: 99394 is listed with $9.8K revenue (0.0% of total Medicaid revenue) and many other frequently billed codes are characterized as typical or unremarkable in volume by their state percentile ranks (for example, 99394 at the 10th percentile, various dental and lab codes in mid percentiles). These observations reinforce that financial performance and competitive position are driven overwhelmingly by encounter-based Medicaid reimbursement rather than by discrete high‑revenue procedures.

Medicaid: Complete Services Breakdown

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

44 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	60,130	$410	$24.8M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	20	$650	$9.8K
0013A	N/A	20	$0	$0
0054A	N/A	50	$0	$0
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	260	$0	$0
36416	In this procedure, the provider pricks the patient’s finger, heel, or ear with a pointed instrument and collects specimen of droplets of blood by pressing the pricking site.	40	$0	$0
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	10	$0	$0
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	70	$0	$0
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	10	$0	$0
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	60	$0	$0

Showing 1–10 of 44

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nevada Distribution

Fallon Tribal Health Center — 1 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nevada

Full comparison — all codes billed, vs. Nevada median

44 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	2	60	2,970	$320	$4M
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	606	2,250	290	$60	$138K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	819	2,480	330	$50	$107.6K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	158	450	470	$40	$92K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	13	30	320	$30	$67.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	196	220	130	$80	$57K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	275	330	240	$60	$55.1K
V2020	Frames, purchases	262	320	360	$30	$53.8K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	55	90	290	$20	$51.8K
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	59	70	320	$10	$50.5K

Showing 1–10 of 44

Related Providers

Other providers that share a Tax Identification Number (TIN) with Fallon Tribal Health Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Layne Dameron	NV	Podiatrist	$156.3K	$0
Christopher Chai	NV	Family Medicine Physician	$56.4K	$0

Nearby Providers

Other providers in the same ZIP code as Fallon Tribal Health Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Banner Churchill Community Hospital	NV	Rural Health Clinic/Center	$0	$13.2M
Churchill Council On Alcohol & Other Drugs	NV	Community/Behavioral Health Agency	$0	$12.1M
Banner Churchill Community Hospital	NV	Critical Access Hospital	$0	$7.6M
Homestead Operations, LLC	NV	Assisted Living Facility	$0	$2.7M
Total Renal Care Inc	NV	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2M
Robertson & Koenig Ltd	NV	Optometrist	$0	$1.4M
Christopher Degn	NV	Diagnostic Radiology Physician	$272.2K	$0
Terry Brown	NV	Diagnostic Radiology Physician	$111.2K	$145.9K
Trevor Phan	NV	Internal Medicine Physician	$174.5K	$31.7K
Reynaldo Narag	NV	Internal Medicine Physician	$62.7K	$16K

Fallon Tribal Health Center — Billing Profile & Reimbursement Data

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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