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.

Yakama Indian Health Center (NPI 1528105541)

Field	Value
Entity Type	Organization
Organization	Yakama Indian Health Center
Address	401 Buster Rd
City	Toppenish
State	WA
ZIP	98948
Taxonomy	Federal Public Health Clinic/Center
NPI Enumerated	January 31, 2007

Payer Source	Total Paid
Medicaid	$34M
Medicare	$0

Key Findings

This provider is effectively single‑payer in the available data: there is no Medicare billing on file while total Medicaid revenue is $34M, and the NPI has been enumerated since 2007-01-31 (~19 years ago), indicating a long-established Medicaid-focused operation. The taxonomy as a Federal Public Health Clinic/Center aligns with the heavy Medicaid activity observed and suggests the organization functions as a community clinic rather than a fee‑for‑service specialty practice.

Revenue is extremely concentrated: the precomputed top three Medicaid codes account for 96.8% of the provider's Medicaid revenue, with T1015 alone representing $31.1M (92.0% of Medicaid revenue). This concentration implies that the bulk of the provider’s financial performance depends on one all‑inclusive clinic encounter code rather than a diversified mix of high‑value procedures.

The code mix implies a primary-care, clinic‑encounter model supported by high-volume E/M work: T1015 (Clinic visit/encounter, all-inclusive) has 76.9K claims and $31.1M in revenue, and the complementary E/M codes 99213 (28.8K claims, $1.2M) and 99214 (8.4K claims, $409.4K) are the other top revenue drivers. Together these three codes (T1015, 99213, 99214) drive most Medicaid revenue and point to routine outpatient evaluation and management as the core service line.

State competitive standing on the dominant code is strong by percentile: T1015 ranks #32 of 652 providers in-state (95th percentile), which places the provider above most peers on clinic-encounter volume even though the dataset labels that volume for this code as typical/unremarkable. The E/M codes also sit at high percentiles (99213 ranks #100 of 1863, 95th percentile; 99214 ranks #225 of 1823, 88th percentile), indicating the provider is a high-volume Medicaid outpatient participant relative to many in-state peers.

Beyond primary care, the provider bills substantial ancillary and dental services consistent with a comprehensive clinic: dental codes such as D0140 (5.9K claims, $141.2K) and D1206 (6.7K claims, $94.1K) appear among the top billed items, and lab/diagnostic codes such as 87637 (1.8K claims, $152.6K) and 80050 (2.3K claims, $70.3K) indicate on‑site testing capacity. Immunizations and screening activity are also present (90686: 4K claims, $47.6K; G2023: 4.1K claims, $37.2K), reinforcing that the center provides a broad package of ambulatory services typical for a Federal Public Health Clinic/Center.

Several specific codes appear as notable outliers in state comparisons and may reflect operational emphases: 99211 ranks #8 of 260 (97th percentile; noted as notably above typical state volume), 0002A ranks #17 of 162 (90th percentile; notably above typical), and 0001A ranks #17 of 170 (91th percentile; notably above typical). These rankings indicate unusually high relative volumes for lower‑level visits or specific procedure/service codes compared with peers, which may reflect clinic workflows that rely on allied health staff visits, preventive workflows, or programmatic screening.

The reliance on a single bundled visit code creates operational and reimbursement sensitivity: with T1015 accounting for $31.1M of $34M total Medicaid revenue (92.0%) and the top three codes totaling 96.8% of Medicaid revenue, any changes in payer policy, reimbursement rates, or coding guidance for clinic visit bundles could materially affect overall revenue. From a payer or contract negotiation perspective, this degree of concentration is a key risk lever and a focal point for utilization management or rate review.

Volume metrics demonstrate sustained patient throughput consistent with community clinic scale: high claim counts such as 76.9K claims for T1015 and 28.8K claims for 99213 signal continuous ambulatory demand, while the provider’s ~19‑year enumeration supports that these volumes are not a transient phenomenon. Taken together, the data portray an established federally aligned clinic with broad ambulatory, dental, diagnostic, and vaccination services concentrated in Medicaid billing rather than a diversified multi‑payer revenue base.

Medicaid: Complete Services Breakdown

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

123 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	76,920	$400	$31.1M
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…	28,770	$40	$1.2M
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…	8,360	$50	$409.4K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	1,820	$80	$152.6K
D0140	Limited oral evaluation – problem focused	5,880	$20	$141.2K
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.	8,110	$10	$97.3K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	6,720	$10	$94.1K
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	2,270	$30	$70.3K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	1,320	$40	$52.7K
D0220	Intraoral - periapical first radiographic image	6,200	$10	$49.6K

Showing 1–10 of 123

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

Yakama Indian Health Center — 2 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

123 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	32	650	4,110	$250	$4.9M
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	92	120	2,040	$30	$464.9K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	93	120	2,020	$30	$441.1K
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…	225	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…	100	1,860	610	$40	$295.5K
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	33	90	1,030	$30	$246.3K
87661	The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique.	58	60	1,340	$30	$208.1K
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.	132	240	2,430	$10	$194.2K
D2392	Post 2 surface resin‑based composite	363	540	990	$60	$188.6K
99391	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…	235	280	540	$70	$166.5K

Showing 1–10 of 123

Related Providers

Other providers that share a Tax Identification Number (TIN) with Yakama Indian Health Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rory Sumners	WA	Family Medicine Physician	$55.6K	$0
Danial Hocson	WA	Family Medicine Physician	$51.7K	$0
Reuben Ramoz	WA	Internal Medicine Physician	$43.1K	$0
Franklin Newhouse	WA	Family Medicine Physician	$16.5K	$0

Nearby Providers

Other providers in the same ZIP code as Yakama Indian Health Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Yakima Valley Farm Workers Clinic	WA	Federally Qualified Health Center (FQHC)	$0	$51.9M
Yakima Valley Farm Workers Clinic	WA	Federally Qualified Health Center (FQHC)	$0	$19.8M
Shc Medical Center Toppenish	WA	General Acute Care Hospital	$0	$15.1M
Yakima Valley Farm Workers Clinic	WA	Federally Qualified Health Center (FQHC)	$0	$13.8M
Yakima Valley Farm Workers Clinic	WA	Federally Qualified Health Center (FQHC)	$0	$6.6M
Olney Emergency Group, A Professional LLC	WA	Emergency Medicine Physician	$0	$3.4M
Laboratory Corporation Of America	WA	Clinical Medical Laboratory	$410	$100.5K
Christine Malino	WA	Surgery Physician	$36.3K	$120
Andreas Schneider	WA	Surgery Physician	$23.7K	$0

Yakama Indian Health Center — Billing Profile & Reimbursement Data

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Yakama Indian 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