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.

Unity Care Northwest (NPI 1760430532)

Field	Value
Entity Type	Organization
Organization	Unity Care Northwest
Address	220 Unity St
City	Bellingham
State	WA
ZIP	98225
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	May 4, 2006

Payer Source	Total Paid
Medicaid	$33.7M
Medicare	$0

Key Findings

This provider effectively operates on a single-payer Medicaid footprint: there is no Medicare billing on file while lifetime Medicaid revenue is $33.7M, indicating Medicaid is the dominant — and for practical purposes the only — public payer driving this organization’s billing activity. Analysts should treat Medicare-related comparisons as inapplicable when evaluating payer mix or risk exposure.

Revenue is highly concentrated: the precomputed top 3 Medicaid codes account for 73.3% of this provider’s total Medicaid revenue, and a single code, T1015, makes up $20M or 60.5% of Medicaid revenue. That concentration signals heavy dependence on FQHC bundled encounter payments for overall revenue stability and highlights a single-code exposure if payment policy or utilization patterns shift.

The code mix is consistent with a Federally Qualified Health Center model: dominant T1015 (clinic visit/encounter, all-inclusive) plus G0467 and large volumes of outpatient E/M codes (99213, 99214, 99215) indicate a broad primary care ambulatory platform that pairs bundled FQHC encounters with traditional E/M activity. Substantial psychotherapy codes (90834, 90837, 90832) and numerous dental codes show integrated behavioral health and dental services embedded in the clinical offering rather than a single-service clinic.

Competitive standing in-state is strong for core services. T1015 ranks #23 of 652 providers in-state (97th percentile; labelled typical, unremarkable volume for this code) while 99213 ranks #38 of 1863 (98th percentile; notably above typical state volume) and 90834 ranks #15 of 391 (96th percentile; notably above typical state volume), indicating the organization is a major Medicaid participant for primary care and psychotherapy relative to peers.

The provider shows a robust dental services footprint: multiple dental codes appear in the top 25 with high claim counts and elevated ranks — for example D0120 (32.5K claims, $845.3K revenue) ranks #38 of 918 (96th percentile; notably above typical) and D1206 (45.3K claims, $725.2K revenue) ranks #16 of 725 (98th percentile; notably above typical). These data indicate sustained pediatric and preventive dental activity alongside restorative procedures (D2392, D2391), supporting a multi-disciplinary community health center model.

Behavioral health is a meaningful revenue stream: psychotherapy codes together account for $1.7M (90834, 5.0% of Medicaid revenue) and $1.3M (90837, 3.9%), with 90834 ranking #15 of 391 (96th percentile; notably above typical state volume). The presence of H0004 at more modest rank and revenue suggests that while psychotherapy visits are a strength, per-15-minute counseling billing is not the primary behavioral health driver.

There are notable statistical outliers and unusually high relative volumes in select codes that merit attention for utilization or capacity analysis. D0190 (no description available) is an extreme outlier, ranking #2 of 86 providers in-state (99th percentile; far above typical state volume), and other codes like D0274 and G0467 show ranks in the top decile (D0274 #11 of 602, 98th percentile; G0467 #6 of 165, 97th percentile; both labelled notably above typical), suggesting programmatic emphasis or specialty capacity in those service lines.

The provider’s NPI tenure (enumerated 2006-05-04, ~20 years ago) combined with $33.7M lifetime Medicaid revenue suggests an established FQHC with sustained Medicaid relationships and operational longevity in its market. For payers and competitors, this indicates a mature organization with entrenched Medicaid service delivery rather than a recent or transient entrant.

Medicaid: Complete Services Breakdown

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

111 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	95,590	$210	$20M
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…	71,270	$40	$2.6M
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…	17,290	$100	$1.7M
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…	32,490	$50	$1.6M
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…	13,140	$100	$1.3M
D0120	Periodic oral evaluation - established patient	32,510	$30	$845.3K
D2392	Post 2 surface resin‑based composite	11,120	$70	$733.7K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	45,320	$20	$725.2K
D2391	Resin‑based composite – one surface, posterior	9,370	$50	$506.1K
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…	7,870	$60	$479.8K

Showing 1–10 of 111

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

Unity Care Northwest — 9 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

111 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	23	650	4,110	$250	$4.9M
H0004	Behavioral health counseling and therapy, per 15 minutes	168	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…	198	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…	64	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…	38	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…	59	930	680	$60	$259.2K
D2392	Post 2 surface resin‑based composite	41	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…	212	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…	218	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…	15	390	420	$50	$152.3K

Showing 1–10 of 111

Related Providers

Other providers that share a Tax Identification Number (TIN) with Unity Care Northwest, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Unity Care Northwest	WA	Federally Qualified Health Center (FQHC)	$0	$20.1M
Unity Care Northwest	WA	Federally Qualified Health Center (FQHC)	$0	$15.4M

Nearby Providers

Other providers in the same ZIP code as Unity Care Northwest, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Peacehealth	WA	Rural Acute Care Hospital	$0	$47.1M
Peacehealth	WA	Internal Medicine Physician	$0	$26.1M
Whatcom Medic One	WA	Land Ambulance	$894.1K	$20.7M
Northwest Pathology PLLC	WA	Anatomic Pathology & Clinical Pathology Physician	$860.5K	$17.8M
Northwest Regional Council	WA	Transportation Broker	$0	$11.4M
Lake Whatcom Residential & Treatment Center	WA	Community/Behavioral Health Agency	$0	$10.3M
Total Renal Care, Inc.	WA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$5.9M
Catholic Community Services Of Western Washington	WA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$5.8M
Apple Pediatric Dentistry	WA	Pediatric Dentistry	$0	$5.8M
Wchs, Inc	WA	Methadone Clinic	$141.1K	$4.5M

Unity Care Northwest — Billing Profile & Reimbursement Data

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Unity Care Northwest — 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