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NPI 1184729493 · Winslow, AZ · Federal Public Health Clinic/Center
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Winslow Indian Health Care Center, Inc is a federal public health clinic/center provider located in Winslow, Arizona. This profile covers 2 Medicare and 17 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Winslow Indian Health Care Center, Inc |
| Address | 500 N Indiana Ave |
| City | Winslow |
| State | AZ |
| ZIP | 86047 |
| Taxonomy | Federal Public Health Clinic/Center |
| NPI Enumerated | September 13, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $121.2M |
| Medicare | $29.9K |
This provider’s revenue is overwhelmingly Medicaid-driven: total Medicaid revenue is $121.2M compared with total Medicare revenue of $29.9K, indicating the organization is effectively single-payer in scale with Medicaid as the dominant source of funds. The NPI has been enumerated since 2006-09-13 (~20 years ago), so this is a long-standing Medicaid-focused operation rather than a new entrant.
Medicaid revenue is extremely concentrated in a single outpatient E/M code: top 3 Medicaid codes by revenue account for 99.9% of this provider's total Medicaid revenue, with 99213 alone contributing $120.9M (99.7% of Medicaid revenue) across 227.2K claims at an average paid/claim of $532. This concentration signals that routine established-patient office visits are the core service and primary revenue driver.
Medicare revenue is tiny in absolute terms and concentrated in ambulance transport: top 3 Medicare codes by revenue account for 100.0% of this provider's total Medicare revenue, split between A0427 ($16.6K, 55.4% of Medicare revenue; 34 claims, $487 avg paid/claim) and A0425 ($13.3K, 44.6% of Medicare revenue; 1.7K claims, $8 avg paid/claim). The Medicare footprint appears to be limited and focused on ground ambulance services and mileage rather than on outpatient E/M.
The code mix suggests the provider operates primarily as a high-volume outpatient primary care clinic under Medicaid (heavy use of 99213) while also billing Medicare for ground transport services (A0427 and A0425). Ancillary Medicaid codes (e.g., 99211, S0215, 99214, 92014) appear in the mix but represent only a sliver of overall Medicaid revenue, reinforcing that routine E/M visits are the central service line.
Competitive standing in-state for the Medicaid office-visit line is unusually strong: 99213 ranks #8 of 2775 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code), indicating this provider is a dominant source of established-patient visits in Arizona. By contrast, most other Medicaid codes list typical, unremarkable state-level ranks, so dominance is concentrated in that single E/M service.
On the Medicare side the provider is a modest national participant: A0427 ranks #5819 of 6841 providers nationally (14th percentile; typical, unremarkable volume) and A0425 ranks #5765 of 8934 providers nationally (35th percentile; typical, unremarkable volume). Those percentiles and rank labels indicate ambulance billing to Medicare is present but not a major national competitive strength.
Operational and payer-risk implications flow from the revenue concentration: with 99213 accounting for $120.9M of $121.2M in Medicaid receipts and top 3 Medicaid codes accounting for 99.9% of Medicaid revenue, changes to Medicaid reimbursement, coding rules, or visit patterns for established outpatient E/M services would materially affect this provider’s revenue. Medicare exposure is minimal ($29.9K) so overall financial sensitivity is concentrated on Medicaid policy and volume for 99213.
The combination of a ~20-year tenure, a Federal Public Health Clinic/Center taxonomy, and the observed code mix (very high-volume 99213 Medicaid billing plus limited Medicare ambulance claims) suggests a stable, community-oriented primary care operation that also provides transportation services; strategic or payer negotiations should treat Medicaid E/M capacity and visit volume as the organization’s principal asset and point of leverage.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 2 CPT/HCPCS codes.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
17 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 227,180 | $530 | $120.9M |
| 99211 | An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional. | 400 | $430 | $170.7K |
| S0215 | Non-emergency transportation; mileage, per mile | 1,000 | $70 | $65K |
| 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… | 1,900 | $30 | $58.9K |
| 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… | 1,120 | $40 | $45K |
| 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… | 400 | $40 | $16.6K |
| 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,… | 920 | $10 | $12.8K |
| A0120 | Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems | 1,000 | $10 | $9K |
| 99442 | N/A | 100 | $30 | $2.9K |
| 11042 | The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2. | 80 | $30 | $2.2K |
Showing 1–10 of 17
How this provider's Medicaid billing volume and revenue compare to other Arizona providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Arizona median
17 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| S0215 | Non-emergency transportation; mileage, per mile | 368 | 510 | 4,610 | $40 | $1.2M |
| 99211 | An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional. | 146 | 400 | 200 | $120 | $403K |
| 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… | 1,048 | 3,040 | 750 | $50 | $343.9K |
| 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… | 40 | 150 | 250 | $60 | $293.9K |
| A0120 | Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems | 386 | 510 | 5,500 | $10 | $267.6K |
| 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… | 8 | 2,780 | 600 | $50 | $267K |
| 11042 | The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2. | 80 | 100 | 590 | $110 | $221.1K |
| 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. | 177 | 200 | 3,310 | $10 | $191.4K |
| 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… | 337 | 930 | 200 | $70 | $97.7K |
| 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,… | 212 | 850 | 230 | $40 | $72.5K |
Showing 1–10 of 17
Other providers in the same ZIP code as Winslow Indian Health Care Center, Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Winslow Memorial Hospital Inc | AZ | Critical Access Hospital | $0 | $38M |
| Dilkon Medical Center | AZ | Federal Public Health Clinic/Center | $0 | $14.7M |
| Action Medical Service Inc. | AZ | Land Ambulance | $291.5K | $10M |
| Winslow Guidance Associates, Inc. | AZ | Community/Behavioral Health Agency | $0 | $8.8M |
| Larry Schramm | AZ | Internal Medicine Physician | $62.9K | $0 |
| Christine Villarino | AZ | Cardiovascular Disease Physician | $48.6K | $0 |
| Michael Stitzer | AZ | Neurology Physician | $45.5K | $0 |
| Bich Hoa Nguyen | AZ | Adult Medicine Physician | $38.2K | $0 |
| William Kvien | AZ | Emergency Medicine Physician | $20.6K | $0 |
| Pearish Smith | AZ | Family Medicine Physician | $10.8K | $0 |
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