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.

Sea-mar Community Health Center (NPI 1356487318)

Field	Value
Entity Type	Organization
Organization	Sea-mar Community Health Center
Address	1040 S Henderson St
City	Seattle
State	WA
ZIP	98108
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	January 29, 2007

Payer Source	Total Paid
Medicaid	$42.4M
Medicare	$0

Key Findings

SEA-MAR is effectively a single-payer Medicaid provider: there is no Medicare billing on file and lifetime Medicaid revenue is $42.4M, indicating the organization’s scale and reimbursement exposure are concentrated entirely in the Medicaid program. This limits any Medicare-based benchmarking or revenue diversification analysis for this entity.

Revenue concentration is high: the precomputed top three Medicaid codes account for 54.8% of total Medicaid revenue, driven by 99213 ($8.3M, 21.5% of Medicaid revenue), 90834 ($7.5M, 19.5% of Medicaid revenue), and G9149 ($5.4M, 13.9% of Medicaid revenue). That level of concentration implies that shifts in outpatient established visits, psychotherapy delivery, or medical-home payments would materially affect the provider’s topline.

The code mix shows an integrated primary care plus behavioral-health model consistent with an FQHC: high-volume primary care E/M codes such as 99213 (251.5K claims, $33 avg paid/claim) and 99214 (79.4K claims, $53 avg paid/claim) sit alongside large psychotherapy volumes 90834 (77.7K claims, $97 avg paid/claim) and 90837 (32.3K claims, $127 avg paid/claim), plus medical-home codes G9149/G9150. This combination suggests SEA-MAR operates broad ambulatory services that concurrently deliver pediatric and adult preventive care, chronic disease management, and substantial behavioral health services.

Competitive standing in-state is dominant for many core Medicaid services: 99213 ranks #4 of 1863 providers in-state (100th percentile; extreme outlier), 90834 ranks #2 of 391 providers in-state (100th percentile; extreme outlier), and several preventive and vaccination codes (for example 99393, 90686, 90471) rank at or near #1 and are labeled extreme outliers. Those rankings indicate SEA-MAR is among the highest-volume Medicaid providers in Washington for routine primary care, pediatrics, vaccination, and psychotherapy.

Behavioral-health service lines contribute a large share of revenue and volume and include both outpatient psychotherapy and residential care. Psychotherapy codes 90834 and 90837 together represent a sizable portion of Medicaid revenue ($7.5M and $4.1M respectively) and H0018/H0019 residential codes are present (H0018 $1.2M; H0019 $247.2K), signaling capacity across outpatient and non-hospital residential behavioral-health settings.

Preventive and pediatric services are a clear emphasis: childhood and adolescent well visits 99392 (16K claims, $721.7K revenue) 99393 (18.6K claims, $651K revenue, rank #1 of 315; 100th percentile; extreme outlier) and 99394 (11.5K claims, $425.4K revenue, rank #1 of 278; 100th percentile; extreme outlier) together demonstrate unusually high pediatric preventive volume for the state. High-volume immunization claims (90686 47.4K claims; 90471 31.2K claims) further support a substantial pediatric and population-health prevention footprint.

The provider’s clinical throughput is reflected in claim volume and unit rates: large claim counts for low-reimbursing but high-frequency codes (e.g., 99213 251.5K claims at $33 avg paid/claim; 90686 47.4K claims at $7 avg paid/claim) indicate SEA-MAR relies on volume-driven Medicaid reimbursement across many core services. At the same time, higher-paid but lower-frequency behavioral-health and medical-home codes (e.g., 90834 $97 avg paid/claim; G9149 $203 avg paid/claim) contribute meaningfully to revenue mix.

Tenure and organizational profile: the NPI was enumerated on 2007-01-29 (~19 years ago), indicating a long-standing presence in the market as a Federally Qualified Health Center (FQHC). Combined with the large Medicaid revenue base and repeated high-ranking code positions, the tenure supports the conclusion that SEA-MAR is an established, high-volume Medicaid FQHC with integrated primary care, pediatric preventive services, immunizations, and robust behavioral-health capacity.

Medicaid: Complete Services Breakdown

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

186 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…	251,480	$30	$8.3M
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…	77,730	$100	$7.5M
G9149	National committee for quality assurance - level 2 medical home	26,460	$200	$5.4M
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…	79,360	$50	$4.2M
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…	32,300	$130	$4.1M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	4,980	$240	$1.2M
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…	13,660	$60	$860.8K
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…	16,040	$50	$721.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	18,600	$40	$651K
H0004	Behavioral health counseling and therapy, per 15 minutes	10,030	$50	$531.5K

Showing 1–10 of 186

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

Sea-mar Community Health Center — 14 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

186 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	70	650	4,110	$250	$4.9M
H0018	Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem	39	60	8,670	$280	$4.9M
G9149	National committee for quality assurance - level 2 medical home	8	90	1,680	$200	$1.5M
H0019	Behavioral health; long‑term residential (non‑medical, non‑acute care in a residential treatment program where stay is typically longer than 30 days), without room and board, per diem	40	50	4,000	$60	$1.5M
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.	126	170	2,120	$40	$779.1K
H0004	Behavioral health counseling and therapy, per 15 minutes	56	320	2,080	$60	$495.5K
T1002	Rn services, up to 15 minutes	57	60	1,140	$100	$493.3K
96165	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of the patients’ physical health…	35	220	2,880	$50	$431K
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…	24	1,820	480	$60	$379.6K
82075	The lab analyst performs the technical lab test to analyze the quantitative amount of alcohol in a patient’s breath and correlates the measurement to blood alcohol content.	27	30	820	$20	$367.8K

Showing 1–10 of 186

Related Providers

Other providers that share a Tax Identification Number (TIN) with Sea-mar Community Health Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sea Mar Community Health Centers	WA	Federally Qualified Health Center (FQHC)	$0	$14.9M
Sea Mar Community Health Centers	WA	Federally Qualified Health Center (FQHC)	$0	$12.1M
Sea Mar Community Health Centers	WA	Federally Qualified Health Center (FQHC)	$0	$9.4M
Sea Mar Community Health Centers	WA	Federally Qualified Health Center (FQHC)	$0	$9.3M
Sea Mar Community Health Centers	WA	Federally Qualified Health Center (FQHC)	$0	$8.7M
Sea Mar Community Health Centers	WA	Federally Qualified Health Center (FQHC)	$0	$8.6M
Sea Mar Community Health Centers	WA	Federally Qualified Health Center (FQHC)	$0	$8.6M
Sea-mar Community Health Center	WA	Federally Qualified Health Center (FQHC)	$0	$8M
Sea Mar Community Health Centers	WA	Federally Qualified Health Center (FQHC)	$0	$7.8M
Sea Mar Community Health Centers	WA	Federally Qualified Health Center (FQHC)	$0	$7.4M

Nearby Providers

Other providers in the same ZIP code as Sea-mar Community Health Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Of Washington	WA	Air Ambulance	$7.3M	$21.3M
Neighborcare Health	WA	Federally Qualified Health Center (FQHC)	$0	$5.2M
Sea Mar Community Health Center	WA	Case Management Agency	$0	$4.3M
Wesley Wu	WA	MOHS-Micrographic Surgery Physician	$337.6K	$0
Abubakar Abdul-rahman	WA	Primary Care Nurse Practitioner	$76.2K	$0
Kent Wallner	WA	Radiation Oncology Physician	$59.9K	$0
Fasiha Khan	WA	Foot & Ankle Surgery Podiatrist	$54.6K	$0
Nicholas Compton	WA	Dermatology Physician	$43.5K	$0
James Mckee	WA	Foot & Ankle Surgery Podiatrist	$35.5K	$0
Shiyuan Zhu	WA	Speech-Language Pathologist	$35.5K	$0

Sea-mar Community Health Center — Billing Profile & Reimbursement Data

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Sea-mar Community Health Center — 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