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.

Quileute Tribal Council (NPI 1548329105)

Field	Value
Entity Type	Organization
Organization	Quileute Tribal Council
Address	560 Quileute Heights
City	Lapush
State	WA
ZIP	98350
Taxonomy	Clinic/Center
NPI Enumerated	December 8, 2006

Payer Source	Total Paid
Medicaid	$3.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

35 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	7,910	$390	$3.1M
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…	1,610	$30	$43.4K
H0004	Behavioral health counseling and therapy, per 15 minutes	470	$70	$33K
96153	N/A	450	$60	$24.9K
T1017	Targeted case management, each 15 minutes	280	$60	$17.8K
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,…	680	$20	$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…	190	$50	$9K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	480	$10	$6.3K
D0140	Limited oral evaluation – problem focused	350	$20	$6K
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.	580	$10	$5.8K

Showing 1–10 of 35

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

Quileute Tribal Council — 0 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

35 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	256	650	4,110	$250	$4.9M
H0004	Behavioral health counseling and therapy, per 15 minutes	236	320	2,080	$60	$495.5K
T1002	Rn services, up to 15 minutes	59	60	1,140	$100	$493.3K
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…	1,204	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…	681	1,860	610	$40	$295.5K
D2392	Post 2 surface resin‑based composite	532	540	990	$60	$188.6K
D0120	Periodic oral evaluation - established patient	576	920	690	$20	$131.3K
D1120	Prophylaxis–child	554	730	690	$20	$112.8K
96153	N/A	167	210	2,910	$20	$105.2K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	407	730	730	$20	$98.5K

Showing 1–10 of 35

Related Providers

Other providers that share a Tax Identification Number (TIN) with Quileute Tribal Council, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Austin Friswold	MI	Podiatrist	$192.1K	$0

Quileute Tribal Council — Billing Profile & Reimbursement Data

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Quileute Tribal Council — 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