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NPI 1497700801 · Reno, NV · Clinic/Center
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Reno Sparks Indian Colony is a clinic/center provider located in Reno, Nevada. This profile covers 1 Medicare and 19 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 | Reno Sparks Indian Colony |
| Address | 1715 Kuenzli Street |
| City | Reno |
| State | NV |
| ZIP | 89502 |
| Taxonomy | Clinic/Center |
| NPI Enumerated | May 23, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $47.4M |
| Medicare | $390 |
Provider is effectively single-payer in scale: lifetime Medicare revenue is $390 versus lifetime Medicaid revenue of $47.4M, indicating the organization’s operations are overwhelmingly funded through Medicaid rather than Medicare. This extreme imbalance suggests the entity functions primarily as a Medicaid-serving clinic rather than a Medicare-facing outpatient provider.
Medicaid revenue is highly concentrated: the precomputed top 3 Medicaid codes by revenue account for 100.0% of the provider’s Medicaid revenue, with T1015 (Clinic visit/encounter, all-inclusive) alone reported as $47.4M (90.3K claims, $525 avg paid/claim) and labeled an extreme outlier. The rank of T1015 at #1 of 58 in-state confirms the provider is an outlier in volume for this bundled clinic-visit code compared with in-state peers.
Medicare revenue is minimal and narrowly concentrated: the precomputed top 3 Medicare codes by revenue account for 100.0% of the provider’s Medicare revenue, and 92250 (fundus photography) represents the entirety of reported Medicare dollars at $390 (13 claims, $30 avg paid/claim). The national ranking for 92250 is #23609 of 25087 (4th percentile; typical, unremarkable volume), so the provider is a modest national participant for this ophthalmic imaging code.
Service-line implications from the code mix point to a community clinic model: T1015’s dominance indicates the provider bills broad, all-inclusive clinic encounters as the primary revenue mechanism, consistent with a Clinic/Center taxonomy. The presence of 92250 in Medicare suggests the clinic also offers episodic diagnostic ophthalmic imaging, but at very low Medicare volume relative to its Medicaid clinic-visit activity.
Billing pattern signals bundled or non-fee-for-service reimbursement for many encounter-level services: several high-frequency Medicaid codes appear with nonzero claim counts but $0 avg paid/claim and $0 revenue (examples include 87635 with 402 claims, 90837 with 291 claims, and 99213 with 425 claims). This pattern is consistent with payments being captured under the all-inclusive T1015 line or alternative payment arrangements rather than itemized fee-for-service reimbursements.
Competitive standing differs sharply by payer: statewide, the provider is dominant for T1015 (rank #1 of 58, 100th percentile, described as an extreme outlier), indicating a major role in delivering Medicaid clinic visits in Nevada; nationally, its Medicare footprint is negligible and ranks in a low percentile for its single Medicare top code. Analysts should treat the provider as a leading Medicaid clinic within the state but a modest Medicare participant.
Tenure supports an established local presence: the NPI was enumerated on 2006-05-23 (~20 years ago), indicating long-standing operation. Combined with the Medicaid-volume dominance, this longevity is consistent with an established safety-net or community clinic role that has operated at scale for Medicaid beneficiaries over many years.
Financial concentration risk is high because Medicaid T1015 drives virtually all Medicaid revenue (precomputed top-3 share 100.0%). Any material change in Medicaid policy, T1015 rate-setting, or state-level payment methodology could disproportionately affect this provider’s revenue given its dependence on a single high-revenue code.
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 |
|---|---|---|---|---|
| 92250 | Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,… | 10 | $30 | $390 |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 1 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
1 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 92250 | 178 | 200 | 40 | $30 | $2.9K |
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.
19 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 90,280 | $530 | $47.4M |
| 0011A | N/A | 40 | $0 | $0 |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 110 | $0 | $0 |
| 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. | 60 | $0 | $0 |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 10 | $0 | $0 |
| 83036 | Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).… | 70 | $0 | $0 |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 10 | $0 | $0 |
| 85025 | A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a… | 10 | $0 | $0 |
| 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… | 400 | $0 | $0 |
| 90460 | In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age. | 50 | $0 | $0 |
Showing 1–10 of 19
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
19 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 1 | 60 | 2,970 | $320 | $4M |
| 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… | 532 | 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… | 1,431 | 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… | 1,116 | 2,480 | 330 | $50 | $107.6K |
| 90460 | In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age. | 273 | 310 | 410 | $40 | $95K |
| 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. | 106 | 130 | 1,600 | $1 | $74.9K |
| V2020 | Frames, purchases | 305 | 320 | 360 | $30 | $53.8K |
| 85025 | A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a… | 155 | 160 | 1,190 | $1 | $39.8K |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 79 | 80 | 1,010 | $1 | $38.4K |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 80 | 80 | 1,140 | $1 | $37.4K |
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Other providers in the same ZIP code as Reno Sparks Indian Colony, ranked by combined Medicare and Medicaid revenue.
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