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.

Kalispel Indian Community Of The Kalispel Reservation Washington (NPI 1396937769)

Field	Value
Entity Type	Organization
Organization	Kalispel Indian Community Of The Kalispel Reservation Washington
Address	1821 Leclerc Rd N
City	Cusick
State	WA
ZIP	99119
Taxonomy	General Practice Physician
NPI Enumerated	August 9, 2007

Payer Source	Total Paid
Medicaid	$6.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	13,680	$450	$6.1M
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…	4,190	$40	$163.4K
D0140	Limited oral evaluation – problem focused	1,490	$30	$37.1K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	590	$40	$26K
D0120	Periodic oral evaluation - established patient	610	$30	$16.5K
D0150	Comprehensive oral evaluation – new or established patient	480	$30	$16.3K
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…	220	$50	$10K
D0220	Intraoral - periapical first radiographic image	1,010	$10	$8.1K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	330	$20	$8K
D2392	Post 2 surface resin‑based composite	110	$70	$7.7K

Showing 1–10 of 23

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

Kalispel Indian Community Of The Kalispel Reservation Washington — 0 of 23 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

23 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	205	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…	1,163	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…	405	1,860	610	$40	$295.5K
D2392	Post 2 surface resin‑based composite	436	540	990	$60	$188.6K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	353	480	1,160	$30	$180.9K
D0120	Periodic oral evaluation - established patient	475	920	690	$20	$131.3K
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…	396	540	130	$90	$128.6K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	146	210	690	$40	$114.5K
D1120	Prophylaxis–child	529	730	690	$20	$112.8K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	304	390	640	$50	$98.8K

Showing 1–10 of 23

Related Providers

Other providers that share a Tax Identification Number (TIN) with Kalispel Indian Community Of The Kalispel Reservation Washington, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kalispel Tribe-camas Institute	WA	Community/Behavioral Health Agency	$0	$6M
Thomasin Hammer	WA	Podiatrist	$112.8K	$0
Clayton Kersting	WA	Family Medicine Physician	$19.6K	$0

Kalispel Indian Community Of The Kalispel Reservation Washington — Billing Profile & Reimbursement Data

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Kalispel Indian Community Of The Kalispel Reservation Washington — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Frequently Asked Questions

References