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.

Muckleshoot Indian Tribe (NPI 1558448175)

Field	Value
Entity Type	Organization
Organization	Muckleshoot Indian Tribe
Address	17500 Se 392nd St
City	Auburn
State	WA
ZIP	98092
Taxonomy	Clinic/Center
NPI Enumerated	November 1, 2006

Payer Source	Total Paid
Medicaid	$36.9M
Medicare	$0

Key Findings

This entity is effectively a Medicaid-focused clinic: there is no Medicare billing on file and the provider reports $36.9M in lifetime Medicaid revenue. The taxonomy is Clinic/Center and the NPI was enumerated 2006-11-01 (~20 years ago), indicating an established, long-standing operation in Auburn, WA.

Revenue is highly concentrated: the precomputed top-3 Medicaid codes together account for 94.6% of the provider's total Medicaid revenue, with a single code, T1015, contributing $33.7M or 91.5% of Medicaid revenue. T1015 also appears at very high volume (83.1K claims) with a high average paid per claim ($405 avg paid/claim), making it the dominant revenue driver for this provider.

The dominance of T1015 (T1015 – Clinic visit/encounter, all-inclusive) suggests the organization operates as a broad, all-inclusive clinic model that bills a bundled clinic-visit encounter as its primary service line. That mix is consistent with tribal or community clinic models that capture the bulk of revenue through an encounter-based clinic visit code rather than through fee-for-service specialty procedures.

Behavioral health is a clear secondary service line: H0004 (behavioral health counseling and therapy) and psych-related codes such as 96153 and 96165 appear in the top codes, with H0004 generating $566.7K (8.9K claims, $64 avg paid/claim) and 96153 generating $557.7K (7.7K claims, $72 avg paid/claim). These volumes indicate an active behavioral health program (including group-based services reflected in 96165), but each of these codes represents only a small share of total Medicaid revenue compared with T1015.

Competitive standing is mixed by service line: for the dominant clinic-visit code T1015 the provider ranks #27 of 652 in-state (96th percentile), signaling major statewide presence for that specific code. By contrast, behavioral health codes rank in more typical statewide positions (e.g., H0004 #61 of 317, 81th percentile; 96153 #45 of 208, 79th percentile), indicating modest but routine participation in those markets rather than outright dominance.

The claims and code mix show multidisciplinary services beyond primary clinic visits: in addition to behavioral health codes, the file includes dental codes (D0120 $70.9K; D1110 $28K), ophthalmology (92014 $80.3K), and psychotherapy/evaluation CPTs (90837, 90834, 90791), which together point to a clinic-level service array that combines primary care, behavioral health, dental and eye care. These ancillary service lines contribute meaningful access breadth even though none approach the revenue share of T1015.

The provider's financial profile is concentrated both by dollar and by encounter: T1015’s $33.7M (91.5% of Medicaid revenue) dominance means the provider’s Medicaid revenue is largely dependent on one encounter-based payment type. This concentration creates exposure to any policy or reimbursement changes affecting how clinic/encounter services are paid under Medicaid, and it means strategic shifts in billing or service mix would materially affect reported Medicaid revenue.

Operational scale is demonstrated by high claim volumes across multiple codes: beyond the 83.1K T1015 claims, the provider submitted thousands of claims for behavioral group services (e.g., 8.9K claims for 96165), counseling (8.9K claims for H0004), and routine dental and vision services. Combined with the NPI tenure listed as 2006-11-01 (~20 years ago), these volumes support the characterization of an established clinic with sustained, high-volume Medicaid activity.

Medicaid: Complete Services Breakdown

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

73 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	83,100	$410	$33.7M
H0004	Behavioral health counseling and therapy, per 15 minutes	8,850	$60	$566.7K
96153	N/A	7,750	$70	$557.7K
96165	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of the patients’ physical health…	8,920	$60	$499.3K
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…	9,800	$40	$382.3K
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…	4,730	$60	$260K
96164	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of the patients’ physical health…	8,930	$20	$151.8K
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,…	3,220	$30	$83.6K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	1,340	$60	$80.3K
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…	1,080	$70	$77.8K

Showing 1–10 of 73

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

Muckleshoot Indian Tribe — 1 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

73 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	27	650	4,110	$250	$4.9M
H0004	Behavioral health counseling and therapy, per 15 minutes	61	320	2,080	$60	$495.5K
96165	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of the patients’ physical health…	59	220	2,880	$50	$431K
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…	316	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…	254	1,860	610	$40	$295.5K
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…	371	930	680	$60	$259.2K
D2392	Post 2 surface resin‑based composite	310	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…	360	480	1,160	$30	$180.9K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	173	390	420	$50	$152.3K
96164	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of the patients’ physical health…	61	230	3,070	$20	$135.6K

Showing 1–10 of 73

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nancy Becker	WA	Otolaryngology Physician	$182.2K	$0

Nearby Providers

Other providers in the same ZIP code as Muckleshoot Indian Tribe, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Juie Mesvani	WA	Physical Therapist	$87.3K	$0
Leslie Falch	WA	Surgical Physician Assistant	$23.5K	$0

Muckleshoot Indian Tribe — Billing Profile & Reimbursement Data

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Muckleshoot Indian Tribe — 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