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

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

Us Health Dept Of Health & Human Services (NPI 1023174299)

Field	Value
Entity Type	Organization
Organization	Us Health Dept Of Health & Human Services
Address	Black Coal Drive, #29
City	Fort Washakie
State	WY
ZIP	82514
Taxonomy	Federal Public Health Clinic/Center
NPI Enumerated	December 29, 2006

Payer Source	Total Paid
Medicaid	$26.1M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and is effectively single-payer from a claims perspective, with total Medicaid revenue reported as $26.1M. The absence of Medicare activity means Medicaid policy and rates will drive nearly all revenue outcomes for this entity.

Medicaid revenue is extremely concentrated: the top three Medicaid codes account for 100.0% of the provider's Medicaid revenue, led by T1015 at $25.3M (97.1% of Medicaid revenue). The other two top codes are D9999 at $749.1K (2.9%) and 99213 at $15.6K (0.1%), underscoring a dependence on a single dominant reimbursement code.

T1015 (Clinic visit/encounter, all-inclusive) dominating revenue indicates this site operates as a comprehensive clinic or federal public health center where broad primary care and related services are captured under an all-inclusive clinic visit. The prominence of T1015 is consistent with the provider taxonomy (Federal Public Health Clinic/Center) and suggests most discrete services (immunizations, basic labs, dental prevention) are managed within bundled clinic encounters.

Competitive standing on key codes shows a strong in-state role for clinic and visit volume: T1015 ranks #2 of 53 providers in-state (98th percentile; notably above typical state volume for this code) and 99213 ranks #6 of 257 (98th percentile; notably above typical state volume for this code). D9999, by contrast, ranks #3 of 6 (60th percentile; typical, unremarkable volume for this code), indicating the provider is a major player for bundled clinic visits and E/M encounter volume but only a modest participant on the miscellaneous code.

Claims-level activity shows many high-count CPT/HCPCS entries with $0 avg paid/claim (examples include 99214, 81003, 90686, 87635, D1351 and several vaccine product codes such as 91300/91301). This pattern is consistent with services being billed as part of an all-inclusive T1015 clinic encounter rather than reimbursed separately, which explains why large claim volumes for those codes do not translate into separate Medicaid revenue.

Operational nuance: 99213 has 15.6K claims but accounts for only $15.6K in revenue, which, together with the dominance of T1015, suggests many E/M encounters are recorded for visit tracking or internal coding while payment flows primarily through the all-inclusive clinic code. D9999 contributes $749.1K and may represent miscellaneous or non-standard billed items, but it remains a small share relative to T1015.

Provider tenure is long-standing: the NPI was enumerated on 2006-12-29 (~20 years ago), indicating an established presence in the community and likely sustained relationships with state Medicaid administration and local patient populations. Sustained enrollment increases the plausibility that current billing patterns reflect an intentional clinic-level payment model rather than a temporary practice configuration.

Analytic implication for payers and network planners: because $25.3M (97.1% of Medicaid revenue) is concentrated in a single all-inclusive clinic code, any changes to Medicaid bundling rules, clinic-rate adjustments, or eligibility policy could materially affect this provider's revenue profile. Monitor T1015 utilization and state policy changes closely when modeling network capacity or negotiating clinic-level rates.

Medicaid: Complete Services Breakdown

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

51 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	55,290	$460	$25.3M
D9999	N/A	2,730	$270	$749.1K
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…	15,610	$1	$15.6K
0001A	N/A	250	$0	$0
0002A	N/A	250	$0	$0
0011A	N/A	90	$0	$0
0012A	N/A	90	$0	$0
0031A	N/A	10	$0	$0
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	100	$0	$0
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	10	$0	$0

Showing 1–10 of 51

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wyoming Distribution

Us Health Dept Of Health & Human Services — 2 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wyoming

Full comparison — all codes billed, vs. Wyoming median

51 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	2	50	1,690	$360	$3.3M
D9999	N/A	3	10	1,490	$450	$1.3M
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…	92	220	400	$50	$79.3K
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…	6	260	420	$30	$67.2K
D1351	Sealant - per tooth	6	30	200	$30	$64.6K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	15	100	130	$30	$46.4K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	30	50	280	$70	$43.2K
D1120	Prophylaxis–child	34	100	110	$30	$39.8K
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…	41	80	180	$80	$36.2K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	21	40	170	$70	$34.1K

Showing 1–10 of 51

Nearby Providers

Other providers in the same ZIP code as Us Health Dept Of Health & Human Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shoshone Tribe	WY	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$668.3K
Susan Duncan	WY	Clinical Social Worker	$35.9K	$0

Us Health Dept Of Health & Human Services — Billing Profile & Reimbursement Data

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Us Health Dept Of Health & Human Services — 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

Nearby Providers

Frequently Asked Questions

References