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.

Puyallup Tribal Health Authority (NPI 1063455665)

Field	Value
Entity Type	Organization
Organization	Puyallup Tribal Health Authority
Address	2209 E 32nd St
City	Tacoma
State	WA
ZIP	98404
Taxonomy	Primary Care Clinic/Center
NPI Enumerated	June 13, 2006

Payer Source	Total Paid
Medicaid	$70.4M
Medicare	$0

Key Findings

PUYALLUP TRIBAL HEALTH AUTHORITY bills almost exclusively to Medicaid and has no Medicare billing on file (listed Medicare revenue: none). Its lifetime Medicaid revenue is $70.4M, making this effectively a single-payer (Medicaid-focused) operation based on the available claims data. The provider taxonomy is Primary Care Clinic/Center, and the code mix confirms a clinic-oriented service model.

Revenue concentration is extremely high: the precomputed top 3 Medicaid codes account for 96.7% of the provider's total Medicaid revenue, with a single code driving the vast majority of receipts. T1015 alone generates $65.5M (93.7% of total Medicaid revenue) from 141.7K claims at $462 avg paid/claim, indicating almost all Medicaid revenue flows through an all-inclusive clinic visit/encounter code. The narrow dependence on T1015 implies operational and revenue risk is concentrated in bundled clinic visit billing.

The code mix aligns with a comprehensive ambulatory clinic offering primary care and related services: high-volume use of T1015 (Clinic visit/encounter, all-inclusive) together with significant counts of E/M codes 99213 (35.2K claims, $1.5M) and 99214 (10.8K claims, $538.6K) indicates routine established-patient office visits are a component of care alongside bundled clinic encounters. Preventive and pediatric well-visit codes (99393, 99392, 99391) and a range of dental procedure codes (D0120, D0140, D1120, D1110, D1351) further suggest integrated primary care with onsite dental and pediatric preventive services rather than a narrowly specialized practice.

Competitive standing in-state is strong for the dominant clinic code: T1015 ranks #11 of 652 providers in Washington (98th percentile) and is described as notably above typical state volume for this code, signaling the provider is a major in‑state operator for bundled clinic visits. By contrast, the secondary E/M codes 99213 (rank #82 of 1863, 96th percentile) and 99214 (rank #179 of 1823, 90th percentile) are characterized as typical, unremarkable volumes despite relatively high percentiles, indicating broad but less outsized participation in standard office E/M services.

Testing and specimen-collection services are also present at meaningful scale: 87635 (SARS–CoV‑2 NAAT) produced $356.7K from 7.4K claims (rank #21 of 206, 90th percentile) and G2023 (SARS–CoV‑2 specimen collection) produced $150K from 7.5K claims (rank #3 of 56, 96th percentile). These ranks and volumes imply a notable role in COVID testing operations relative to many in-state peers, complementing the clinic visit volume rather than replacing it.

The presence of a broad set of dental codes with nontrivial counts and revenues—examples include D0120 ($146.4K, 5.2K claims), D1206 ($142.1K, 8.4K claims), and D0140 ($118.3K, 4.7K claims)—indicates a mixed service line with both medical and dental care delivered or billed through the same organizational umbrella. This diversified service mix within the outpatient/clinic setting may reflect integrated community health programming and preventive services for children and adults.

Tenure: the provider NPI was enumerated on 2006-06-13 (~20 years ago), indicating long-standing presence in the market. That multi-decade enrollment combined with concentrated Medicaid revenue suggests an established Medicaid-facing clinic with institutional experience serving its catchment.

Operational implications and risk profile: because $65.5M (93.7% of Medicaid revenue) is tied to a single all-inclusive clinic encounter code (T1015) and the top three codes together represent 96.7% of Medicaid revenue, payers and analysts should treat this provider as highly Medicaid-dependent and functionally concentrated around bundled clinic services. Any changes in how T1015 is reimbursed, audited, or attributed could materially affect this provider’s revenue, while secondary service lines such as E/M visits, testing, and dental care represent much smaller revenue streams in the current data.

Medicaid: Complete Services Breakdown

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

124 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	141,710	$460	$65.5M
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…	35,170	$40	$1.5M
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…	10,770	$50	$538.6K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	7,430	$50	$356.7K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	7,500	$20	$150K
D0120	Periodic oral evaluation - established patient	5,230	$30	$146.4K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	8,360	$20	$142.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,560	$80	$122K
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…	1,520	$80	$118.8K
D0140	Limited oral evaluation – problem focused	4,730	$30	$118.3K

Showing 1–10 of 124

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

Puyallup Tribal Health Authority — 3 of 25 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

124 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	11	650	4,110	$250	$4.9M
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	85	170	2,120	$40	$779.1K
D8080	N/A	73	110	970	$370	$634K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	114	120	2,040	$30	$464.9K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	115	120	2,020	$30	$441.1K
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…	179	1,820	480	$60	$379.6K
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…	82	1,860	610	$40	$295.5K
D8670	N/A	73	90	640	$220	$233K
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.	125	240	2,430	$10	$194.2K
D2392	Post 2 surface resin‑based composite	281	540	990	$60	$188.6K

Showing 1–10 of 124

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Puyallup Tribal Health Authority	WA	Adult Mental Health Clinic/Center	$0	$19.5M
Puyallup Tribal Health Authority	WA	Substance Use Disorder Rehabilitation Clinic/Center	$0	$8.9M
Kris Peterson	WA	Child & Adolescent Psychiatry Physician	$189.1K	$0
Mark Kozakowski	WA	Internal Medicine Physician	$49.8K	$0
James Hooper	WA	Family Medicine Physician	$31.9K	$0
Martina Tam	WA	Family Medicine Physician	$25.6K	$310
Mitchell Kamakeeaina-ornelas	WA	Family Medicine Physician	$21.2K	$0
Mikaela Alger	WA	Family Medicine Physician	$14.3K	$0
Laramie Lunday	WA	Family Medicine Physician	$12K	$0
Angelo Williams	WA	Family Medicine Physician	$11.4K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Smiles 4 Kids PC	WA	General Practice Dentistry	$0	$10.4M
Renal Care Group Northwest, Inc.	WA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.4M
Ross M. Anderson, Anchor Physical Therapy	WA	Physical Therapist	$0	$2.6M
John Ford	WA	Legal Medicine	$105.4K	$950
Nichole Thorsvik	WA	Neuromusculoskeletal Medicine & OMM Physician	$6.1K	$2.3K

Puyallup Tribal Health Authority — Billing Profile & Reimbursement Data

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Puyallup Tribal Health Authority — 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