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.

Public Hospital District No 1 Of Mason County (NPI 1598906455)

Key Findings

Field	Value
Entity Type	Organization
Organization	Public Hospital District No 1 Of Mason County
Address	1701 N 13th St
City	Shelton
State	WA
ZIP	98584
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	March 23, 2009

Payer Source	Total Paid
Medicaid	$35.5M
Medicare	$0

This entity is effectively single‑payer in the dataset: there is no Medicare billing on file and the provider’s entire recorded federal revenue comes from Medicaid, with Total Medicaid revenue: $35.5M. That concentration means analyses of scale, service mix, and market positioning should be framed around Medicaid activity rather than dual‑payer comparisons.

Revenue is highly concentrated in a small set of Medicaid codes: the precomputed top three Medicaid codes account for 93.8% of this provider’s total Medicaid revenue, led by T1015 at 73.9%, followed by 99213 at 11.4% and 99214 at 8.5%. This concentration indicates that a handful of visit‑based codes drive almost all billed Medicaid dollars for the clinic.

The code mix and volumes signal an RHC/primary‑care operational model: T1015 (T1015 – Clinic visit/encounter, all-inclusive) dominates with 134.9K claims and $26.2M revenue, and high volumes of evaluation-and-management codes 99213 (65K claims, $4M) and 99214 (32.3K claims, $3M) reflect routine outpatient primary care visits. The prominence of T1015 — an all‑inclusive clinic visit code used by Rural Health Clinics and similar centers — aligns with the provider’s taxonomy as a Rural Health Clinic/Center and suggests bundled, visit‑level reimbursement is core to its operations.

State competitive standing is strong for the provider’s top visit codes: T1015 ranks #13 of 652 providers in-state (98th percentile) and 99213 ranks #44 of 1863 providers in-state (98th percentile), both described as notably above typical state volume. By contrast, 99214 ranks #65 of 1823 providers (96th percentile) and is labeled as typical, unremarkable volume, indicating dominant performance for low‑complexity visit volume but only typical standing for moderate‑complexity E/M visits.

Behavioral health and telehealth services are present but represent small shares of revenue: psychotherapy code 90834 accounts for $501.8K (1.4% of Medicaid revenue) and ranks #32 of 391 providers in-state (92th percentile; typical, unremarkable volume), while the telehealth RHC distant‑site code G2025 shows 480 claims and $54.7K revenue (0.2% of Medicaid revenue) and ranks #36 of 137 providers in-state (74th percentile; typical, unremarkable volume). These entries indicate integrated behavioral‑health and telehealth capabilities without major revenue impact relative to the clinic’s core T1015 business.

Preventive care and immunizations contribute modestly across multiple codes: 99391 and 99392 together produce roughly $868.1K (1.3% and 1.1% of Medicaid revenue respectively) and rank in the upper state percentiles (88th and 86th) but are still small relative to clinic‑visit revenue; vaccine codes 90686, 90670, 90671 and administration codes 90471/90472 appear at modest revenue levels and generally rank in the mid‑to‑high state percentiles with labels of typical, unremarkable volume. This pattern suggests routine preventive and vaccination services are part of the care mix but not primary revenue drivers.

A few non‑visit screening and preventive instruments show unusually high relative volume for the market: 96110 (developmental screening) reports 6.1K claims with $42.8K revenue and ranks #11 of 176 providers in-state (94th percentile), explicitly described as notably above typical state volume. The presence of elevated developmental‑screening activity alongside dominant T1015 billing implies the clinic likely serves a sizable pediatric or family practice population where brief standardized screenings are regularly administered.

The provider is an established presence locally with a long active NPI: NPI enumerated (registered) 2009-03-23 (~17 years ago). Combined with the coding pattern—heavy reliance on RHC all‑inclusive visits and consistently high state‑percentile rankings for core visit codes—this tenure supports interpretation of an established rural clinic that has built scale in Medicaid visit volume over a sustained period.

Medicaid: Complete Services Breakdown

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

82 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	134,900	$190	$26.2M
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…	64,980	$60	$4M
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…	32,280	$90	$3M
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…	7,600	$70	$501.8K
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…	5,920	$80	$467.8K
99392	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…	4,600	$90	$400.3K
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…	970	$170	$159.7K
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…	1,200	$110	$130.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,280	$80	$105.9K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	1,810	$40	$78K

Showing 1–10 of 82

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

Public Hospital District No 1 Of Mason County — 5 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

82 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	13	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…	65	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…	44	1,860	610	$40	$295.5K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	114	120	640	$100	$259.3K
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…	354	930	680	$60	$259.2K
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…	35	280	540	$70	$166.5K
99392	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…	42	300	400	$80	$164.4K
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…	32	390	420	$50	$152.3K
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…	106	540	130	$90	$128.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	81	320	290	$70	$104.8K

Showing 1–10 of 82

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northwest Indian Treatment Center	WA	Clinic/Center	$0	$17.3M
Fire Protection Dist 5 Mason County	WA	Land Ambulance	$766.4K	$6.9M
Squaxin Island Medical Encounter	WA	Health Service Clinic/Center	$0	$4.6M
Northwest Resources Ii	WA	Addiction (Substance Use Disorder) Counselor	$0	$3.9M
Squaxin Island Tribe	WA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$3.8M
Skokomish Tribal Council	WA	Family Medicine Physician	$0	$3.1M
Patrick Kwong	WA	General Practice Dentistry	$0	$2.5M
Gregory Fulling	WA	Physical Therapist	$65.8K	$0
Edward Herman	WA	Clinical Social Worker	$27K	$0

Public Hospital District No 1 Of Mason County — Billing Profile & Reimbursement Data

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Public Hospital District No 1 Of Mason County — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Public Hospital District No 1 Of Mason County	WA	Critical Access Hospital	$0	$72.3M
Public Hospital District No 1 Of Mason County	WA	Rural Health Clinic/Center	$0	$3.9M
Public Hospital District No 1 Of Mason County	WA	Rural Health Clinic/Center	$0	$3.8M
Ryan Halpin	WA	Neurological Surgery Physician	$756.1K	$0
Andrew Manista	WA	Orthopaedic Surgery Physician	$454.4K	$0
Darrin Trask	WA	Orthopaedic Surgery Physician	$241.1K	$0
Ross Vogelgesang	WA	Pain Medicine (Anesthesiology) Physician	$228.8K	$0
Jerome Zechmann	WA	Orthopaedic Surgery Physician	$214K	$0
Yong Shin	WA	Internal Medicine Physician	$208.3K	$0
Milan Moore	WA	Orthopaedic Surgery Physician	$181.6K	$0