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.

Jamestown S'klallam Tribe (NPI 1134181555)

Field	Value
Entity Type	Organization
Organization	Jamestown S'klallam Tribe
Address	808 N 5th Ave
City	Sequim
State	WA
ZIP	98382
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	April 3, 2006

Payer Source	Total Paid
Medicaid	$37.6M
Medicare	$0

Key Findings

This provider effectively operates as a Medicaid-centric clinic: there is no Medicare billing on file and lifetime Medicaid revenue is $37.6M, so the entity is essentially a single-payer (Medicaid) billing operation rather than a mixed Medicare/Medicaid practice. This concentrated payer profile should be interpreted as the provider’s operations and financial performance being highly dependent on Medicaid program rules and reimbursement levels.

Revenue is extremely concentrated in a handful of codes: the top three Medicaid codes account for 97.5% of the provider’s total Medicaid revenue, with T1015 alone representing $34.8M (92.5% of Medicaid revenue). This indicates the organization bills primarily using a bundled clinic/encounter mechanism rather than a broad mix of discrete CPT services.

The code mix and taxonomy align with operation as a Federally Qualified Health Center: dominant use of T1015 and meaningful volume of G0467 reflects FQHC-style per-visit bundled billing and high-volume ambulatory clinic encounters. The presence of G0467 (30.4K claims, $425.5K revenue) alongside T1015 suggests routine delivery of the typical FQHC service bundle to established patients.

Competitive standing for the primary clinic code is high but described as unremarkable: T1015 ranks #29 of 652 providers in-state (96th percentile) and is characterized in the data as "typical, unremarkable volume for this code," meaning the provider delivers a large absolute volume of bundled clinic visits but is not uniquely dominant statewide for that specific code. Analysts should view the clinic encounter volume as substantial in scale while recognizing many peers also report high volumes for the same bundled visit code.

By contrast, the provider is an outlier on the FQHC-established-patient visit metric: G0467 ranks #2 of 165 providers in-state (99th percentile) and is labeled an "extreme outlier, far above typical state volume for this code." This suggests a localized or organizational strength in reporting FQHC-specific visit services that substantially exceeds most in-state peers, indicating potential operational differentiation among FQHCs.

Evaluation and management codes 99213 and 99214 together represent a small but notable portion of revenue (99213: $1.3M, 3.4%; 99214: $626.3K, 1.7%), with 99213 ranking #53 of 1863 providers (97th percentile, "notably above typical state volume"). That pattern points to frequent, low-to-moderate complexity established-patient office visits being billed in addition to bundled FQHC encounters, consistent with a high-throughput primary care model.

Behavioral health and ancillary services are present but are not major revenue drivers: psychotherapy codes 90834 ($191.7K) and 90837 ($185.8K) each account for roughly 0.5% of Medicaid revenue, and G0470 (mental health FQHC visit) contributes $4.6K. These entries indicate integrated behavioral health capability within the clinic footprint, but mental health and ancillary labs/vaccines remain secondary to core clinic visit revenue.

The provider has long-standing enrollment and operational continuity, with an NPI enumeration date of 2006-04-03 (~20 years ago). This tenure supports interpretation of the observed billing patterns as established and consistent rather than transient, which is relevant for contracting, network planning, and peer-comparison assessments.

Medicaid: Complete Services Breakdown

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

41 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	79,550	$440	$34.8M
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…	55,490	$20	$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…	20,200	$30	$626.3K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	30,400	$10	$425.5K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	4,170	$50	$191.7K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	2,270	$80	$185.8K
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…	4,970	$10	$44.8K
0012A	N/A	860	$30	$23.3K
0011A	N/A	920	$10	$11K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	400	$20	$8.8K

Showing 1–10 of 41

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

Jamestown S'klallam Tribe — 4 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

41 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	29	650	4,110	$250	$4.9M
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…	98	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…	53	1,860	610	$40	$295.5K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	240	930	680	$60	$259.2K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	57	390	420	$50	$152.3K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	483	540	130	$90	$128.6K
Q3014	Telehealth originating site facility fee	72	140	330	$20	$108.7K
99203	The provider sees a new 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 provider…	410	560	140	$70	$88.9K
99204	The provider sees a new 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 provider…	384	530	80	$90	$87.4K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	99	110	380	$20	$72.9K

Showing 1–10 of 41

Related Providers

Other providers that share a Tax Identification Number (TIN) with Jamestown S'klallam Tribe, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jamestown S'klallam Tribe	WA	Substance Use Disorder Rehabilitation Clinic/Center	$0	$30M
Jamestown S'klallam Tribe	WA	Dentist	$0	$21.8M
Jamestown S'klallam Tribe	WA	Federally Qualified Health Center (FQHC)	$0	$2.8M
Jerome Oakes	WA	Family Medicine Physician	$4.7K	$0
Thomas Rambow	ID	Physician Assistant	$3.4K	$0

Nearby Providers

Other providers in the same ZIP code as Jamestown S'klallam Tribe, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Walgreen Co	WA	Pharmacy	$444K	$140
Helen Xiao-li	WA	Radiation Oncology Physician	$368.1K	$0
William Harrer	WA	Medical Oncology Physician	$348K	$0
Costco Wholesale Corporation	WA	Community/Retail Pharmacy	$299.3K	$0
Agnieszka Niemeyer	WA	Dermatology Physician	$266.4K	$0
Britton Moss	WA	Physical Therapist	$261.6K	$0
John Banzer	WA	Cardiovascular Disease Physician	$254.2K	$0
Heidi Hermes Shantz	WA	MOHS-Micrographic Surgery Physician	$251K	$0
Pacific Vascular Incorporated	WA	Physiological Laboratory	$249.5K	$0
Lindsay Jensen	WA	Radiation Oncology Physician	$194K	$0

Jamestown S'klallam Tribe — Billing Profile & Reimbursement Data

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Jamestown S'klallam Tribe — 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