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 Utah for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Utah 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. Utah (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.

Confederated Tribes Of The Goshute Reservation (NPI 1750510277)

Key Findings

Field	Value
Entity Type	Organization
Organization	Confederated Tribes Of The Goshute Reservation
Address	195 Tribal Center Rd
City	Ibapah
State	UT
ZIP	84034
Taxonomy	General Practice Physician
NPI Enumerated	July 6, 2009

Payer Source	Total Paid
Medicaid	$41.3M
Medicare	$0

This provider is effectively single‑payer: there is no Medicare billing on file while Medicaid payments total $41.3M, indicating near‑exclusive reliance on Medicaid for billed revenue. That concentration suggests the organization’s financial performance and access role are tightly coupled to state Medicaid policy and enrollment trends rather than Medicare demand.

Revenue is highly concentrated in a small set of outpatient codes: the top three Medicaid codes (99213, 99214, 90837) account for 75.1% of the provider’s total Medicaid revenue. In particular, 99213 represents $14.7M (36.9%) and 99214 $11.6M (29.2%), so routine evaluation-and-management visits are the dominant revenue drivers.

The code mix points to an ambulatory primary‑care operation with embedded behavioral‑health and allied services: very large volumes of E/M established‑patient visits (99213, 99214) are paired with substantial psychotherapy billing (90837, 90834, 90832, 90853), nutrition/diet codes (97802, 97803), immunizations (90471, 90472) and vision services (92014, V2020). This combination is consistent with a general practice clinic that delivers ongoing chronic care, mental‑health treatment, preventive services, and basic ancillary care on site.

For core ambulatory E/M codes the provider is a dominant statewide actor: 99213 appears on 31.2K claims and ranks #15 of 1355 providers in Utah (99th percentile; labeled an "extreme outlier, far above typical state volume for this code"), and 99214 appears on 23.2K claims and ranks #10 of 1340 (99th percentile; "notably above typical state volume"). Those rankings indicate unusually large patient volume for routine office visits compared with in‑state peers.

Behavioral‑health billing is an important secondary revenue source but not as extreme as E/M volumes: 90837 produced $3.6M (9.1%) on 8.1K claims and ranks #40 of 372 providers in‑state (89th percentile; characterized as typical, unremarkable volume). The presence of multiple psychotherapy codes and group therapy billing (90853) shows sustained capacity in mental‑health care, even if psychotherapy volumes are more comparable to peers than the E/M volumes.

The provider also delivers notable preventive and ancillary services: vaccination administration (90471, 90472) and preventive medicine visits (99392, 99391, 99393) appear in the top codes, and ophthalmic exam billing (92014) and frames (V2020) indicate on‑site eye care. Several of these ancillary codes rank in high percentiles for the state (for example, 90471 is at the 95th percentile), supporting a view of a clinic providing broad primary‑care support services.

The NPI tenure (enumerated 2009-07-06, ~17 years ago) indicates a long‑established practice in the community; combined with the large Medicaid footprint and top‑ranked E/M volumes, this suggests a sustained, central role in local Medicaid care delivery and likely high ongoing patient panel turnover and chronic‑care management demand.

Operationally, the combination of extremely high Medicaid E/M volumes and no Medicare billing implies both market influence within Medicaid and concentrated payer risk: the provider likely has negotiating relevance with state Medicaid plans due to volume in core office‑visit codes, but its revenue exposure is largely tied to state Medicaid reimbursement levels and rules rather than diversified payer mix.

Medicaid: Complete Services Breakdown

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

119 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	31,240	$470	$14.7M
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…	23,160	$500	$11.6M
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…	8,070	$450	$3.6M
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…	3,520	$410	$1.4M
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…	2,590	$430	$1.1M
99203	The provider sees a new 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 provider…	1,510	$480	$726.9K
90832	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…	1,470	$450	$655K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	2,260	$280	$638.2K
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…	1,070	$570	$605.6K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	5,300	$90	$497.9K

Showing 1–10 of 119

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Utah providers billing the same CPT/HCPCS codes.

Claims Volume vs. Utah Distribution

Confederated Tribes Of The Goshute Reservation — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Utah

Full comparison — all codes billed, vs. Utah median

119 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	40	370	690	$140	$704.2K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	61	150	1,060	$70	$528.1K
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…	22	110	270	$120	$439.4K
T1015	Clinic visit/encounter, all-inclusive	36	70	270	$110	$376.1K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	72	140	160	$220	$374.1K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	55	70	1,610	$30	$367.9K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	29	40	770	$90	$231.9K
90832	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…	28	90	270	$70	$200.4K
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…	112	120	1,100	$30	$186.6K
H0031	Mental health assessment, by non-physician	9	10	540	$120	$154K

Showing 1–10 of 119

Confederated Tribes Of The Goshute Reservation — 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

Frequently Asked Questions

References