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.

Upper Skagit Indian Tribe (NPI 1336129295)

Upper Skagit Indian Tribe is a federally qualified health center (fqhc) provider located in Sedro Woolley, Washington. This profile covers 0 Medicare and 10 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Upper Skagit Indian Tribe
Address	25959 Community Plaza Way
City	Sedro Woolley
State	WA
ZIP	98284
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	January 18, 2006

Payer Source	Total Paid
Medicaid	$4.6M
Medicare	$0

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	9,520	$450	$4.3M
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…	3,470	$70	$239.4K
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…	2,390	$40	$83.5K
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…	290	$40	$12.6K
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,…	160	$20	$2.5K
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…	30	$40	$1.4K
90682	This code represents a quadrivalent flu vaccine given by injection into the muscle. The vaccine is made using recombinant DNA technology and contains only a protein from the virus. It does not…	40	$30	$1.2K
90832	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…	20	$30	$680
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	10	$1	$40
90658	This code represents a trivalent influenza vaccine product containing split virus components. It is administered into the muscle in a 0.5 mL dosage.	20	$0	$0

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

Upper Skagit Indian Tribe — 0 of 9 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

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	238	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…	1,081	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…	552	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…	178	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…	350	390	420	$50	$152.3K
90832	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…	312	340	510	$30	$80K
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,…	360	700	180	$50	$59.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	533	550	260	$10	$12.2K
90658	This code represents a trivalent influenza vaccine product containing split virus components. It is administered into the muscle in a 0.5 mL dosage.	39	60	30	$10	$980
90682	This code represents a quadrivalent flu vaccine given by injection into the muscle. The vaccine is made using recombinant DNA technology and contains only a protein from the virus. It does not…	9	40	30	$20	$900

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Peacehealth	WA	Critical Access Hospital	$0	$41.3M
Pioneer Human Services	WA	Substance Abuse Rehabilitation Facility	$0	$6.6M
Sound Physicians Emergency Medicine Of Washington PLLC	WA	Emergency Medicine Physician	$0	$2.7M
Dan Siapco	WA	Ophthalmology Physician	$369.1K	$0
Kevin Lee	WA	Internal Medicine Physician	$310.5K	$0
Janessa Chang	WA	Physical Medicine & Rehabilitation Physician	$159.1K	$0
Herbert Stickle	WA	Family Medicine Physician	$144.2K	$0

Upper Skagit Indian Tribe — Billing Profile & Reimbursement Data

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Upper Skagit Indian Tribe — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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