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NPI 1396778379 · Gardnerville, NV · Clinic/Center
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Washoe Tribe Of Nevada And California is a clinic/center provider located in Gardnerville, Nevada. This profile covers 1 Medicare and 16 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 | Washoe Tribe Of Nevada And California |
| Address | 1559 Watasheamu |
| City | Gardnerville |
| State | NV |
| ZIP | 89460 |
| Taxonomy | Clinic/Center |
| NPI Enumerated | July 10, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $18.3M |
| Medicare | $1.9K |
WASHOE TRIBE OF NEVADA AND CALIFORNIA shows an extremely Medicaid-centric billing profile: lifetime Medicare revenue is $2K while lifetime Medicaid revenue is $18.3M, indicating this entity functions effectively as a Medicaid provider with negligible Medicare receipts. The scale difference suggests payer mix and operational focus are driven almost entirely by Medicaid-funded services rather than Medicare.
Medicaid revenue is highly concentrated in a single code: T1015 accounts for 100.0% of this provider's total Medicaid revenue and generated $18.3M from 41.1K claims. The prominence of T1015 (Clinic visit/encounter, all-inclusive) indicates the organization’s core service line is comprehensive clinic encounters or bundled outpatient visit billing rather than specialty procedures.
The provider is a major in-state clinic for T1015: its rank of #5 of 58 providers in Nevada places it in the 93rd percentile and is described as notably above typical state volume for that code. This competitive standing implies the clinic is one of the principal sources of Medicaid clinic-visit volume in the state, likely serving a sizable patient population or operating multiple service sites under this taxonomy.
Medicare activity is minimal and concentrated: three Medicare codes make up 100.0% of the provider’s Medicare revenue, and the listed Medicare code 99443 accounts for the entire $2K Medicare revenue with 25 claims. With a national rank of #7070 of 14283 (48th percentile) for 99443, the provider’s Medicare participation is modest and unremarkable at the national level.
Service-line implications from the code mix support a primary role as a general clinic/center: the dominance of T1015 (all-inclusive clinic visit) alongside routine outpatient E/M and ancillary codes in the Medicaid listings (e.g., 99211, 99213, 99214, 99212) suggests the organization delivers general primary care and clinic-based services, with some behavioral health and ancillary services also reported.
Claims with $0 average paid/claim appear across many Medicaid codes (including common E/M and therapy codes), which may reflect bundled payment reporting under T1015 or claims processed with zero paid amounts for those specific lines. Analysts should interpret the zero-paid lines cautiously and consider that T1015 likely captures the reimbursed clinic-level payment while other codes appear on encounter records without separate paid amounts.
The provider has longstanding enrollment: the NPI was enumerated on 2006-07-10 (~20 years ago), indicating stable tenure in the provider directory which aligns with its elevated Medicaid volume and established role in the state clinic network. This longevity supports the idea that observed billing patterns reflect an established operational model rather than a short-term activity spike.
Although a few Medicaid codes beyond T1015 are present, none materially contribute to revenue—the precomputed top-3 Medicaid codes explanation shows T1015 drives 100.0% of Medicaid dollars. This concentration suggests limited revenue diversification by procedure and highlights sensitivity to changes in Medicaid clinic visit reimbursement policy.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99443 | N/A | 30 | $80 | $1.9K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 1 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
1 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 99443 | 56 | 80 | 40 | $70 | $4.9K |
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.
16 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 41,080 | $450 | $18.3M |
| H0047 | Alcohol and/or other drug abuse services, not otherwise specified | 30 | $110 | $2.9K |
| 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. | 60 | $10 | $460 |
| 0011A | N/A | 10 | $0 | $0 |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 90 | $0 | $0 |
| 87811 | The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by… | 20 | $0 | $0 |
| 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… | 210 | $0 | $0 |
| 91301 | N/A | 30 | $0 | $0 |
| 92015 | The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced. | 10 | $0 | $0 |
| 97010 | The provider, such as physical therapist, applies a hot or cold pack to a specific body site to treat an injury or disease. | 20 | $0 | $0 |
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How this provider's Medicaid billing volume and revenue compare to other Nevada providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Nevada median
16 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 5 | 60 | 2,970 | $320 | $4M |
| H0047 | Alcohol and/or other drug abuse services, not otherwise specified | 73 | 80 | 1,180 | $70 | $225.2K |
| 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… | 603 | 970 | 360 | $80 | $139.2K |
| 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… | 1,177 | 2,250 | 290 | $60 | $138K |
| 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… | 1,575 | 2,480 | 330 | $50 | $107.6K |
| V2020 | Frames, purchases | 311 | 320 | 360 | $30 | $53.8K |
| 97014 | The provider, who is typically a physical therapist, applies an electrical current to nerves or to a muscle or group of muscles, causing them to contract. It is used to restore function to a body… | 64 | 70 | 590 | $10 | $32K |
| 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,… | 425 | 540 | 130 | $30 | $28K |
| 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. | 223 | 310 | 260 | $10 | $27.2K |
| 87811 | The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by… | 36 | 40 | 150 | $20 | $16K |
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