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.

Stillaguamish Tribe Of Indians (NPI 1790826600)

Field	Value
Entity Type	Organization
Organization	Stillaguamish Tribe Of Indians
Address	5700 172nd St Ne # A
City	Arlington
State	WA
ZIP	98223
Taxonomy	Substance Use Disorder Rehabilitation Clinic/Center
NPI Enumerated	February 12, 2007

Payer Source	Total Paid
Medicaid	$349.6M
Medicare	$0

Key Findings

This provider is effectively single‑payer in scope: there is no Medicare billing on file and the lifetime Medicaid revenue is $349.6M, so Medicaid is the sole measurable public payer revenue stream reported for this NPI. Analysts should treat the entity as a Medicaid‑focused clinic/center rather than a dual‑eligible provider for Medicare/Medicaid comparisons.

Revenue is highly concentrated in a very small set of service codes: the precomputed top 3 Medicaid codes account for 99.7% of this provider's total Medicaid revenue, with T1015 alone representing 95.5% ($333.9M) of Medicaid revenue. This concentration means overall margin and utilization trends will be driven almost entirely by how T1015 is billed and reimbursed.

T1015 (Clinic visit/encounter, all-inclusive) dominates the mix with 946K claims at $353 avg paid/claim and $333.9M revenue; this code is an extreme outlier in the state, ranked #1 of 652 providers (100th percentile). The volume and rank indicate the operation is primarily a clinic‑based, high‑volume ambulatory service model where bundled clinic encounters are the primary product.

The presence of H0020 (methadone administration) at 938.7K claims, $14 avg paid/claim and $13.1M revenue (3.8% of Medicaid revenue) shows the provider also delivers medication‑assisted treatment services. H0020 ranks #5 of 60 providers in-state (93th percentile; typical, unremarkable volume for this code), signaling that methadone services are a substantial secondary line of business but not as uniquely dominant as the T1015 clinic encounters.

H0004 (behavioral health counseling and therapy, per 15 minutes) generates $1.6M and 44.1K claims (0.5% of Medicaid revenue) and ranks #13 of 317 providers in-state (96th percentile; notably above typical state volume). This indicates a meaningful counseling/therapy component to the clinical mix that complements the clinic visits and methadone administration, even though it represents a much smaller share of revenue.

Assessment and testing codes such as 96154 and 96153 appear as additional, specialized services: 96154 (8.4K claims, $278K revenue) ranks #1 of 20 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code), while 96153 (8.1K claims, $259K revenue) ranks #43 of 208 (80th percentile). These ranks suggest unusually high use of certain assessment/test services relative to peers, which may reflect programmatic intake, monitoring, or behavioral health evaluation workflows despite their modest contribution to total revenue.

Claim volumes across the top codes are very large and concentrated in encounter‑level services: 946K claims for T1015 and 938.7K claims for H0020 underline an extremely high encounter throughput model. For payer contracting and network capacity planning, this provider should be treated as a very high‑volume outpatient clinic with sustained per‑encounter billing patterns.

The NPI has a long tenure in the filing system (NPI enumerated 2007-02-12, ~19 years ago), indicating an established provider with long‑standing Medicaid relationships and operational history. That longevity, combined with the extreme concentration in a few codes, suggests stable program operations focused on outpatient clinic encounters and substance‑use disorder services rather than a diversified set of medical specialties.

Medicaid: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	946,000	$350	$333.9M
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	938,670	$10	$13.1M
H0004	Behavioral health counseling and therapy, per 15 minutes	44,090	$40	$1.6M
96154	N/A	8,420	$30	$278K
96153	N/A	8,100	$30	$259K
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…	8,450	$20	$135.2K
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…	1,810	$60	$103K
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…	7,850	$10	$62.8K
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…	660	$90	$56.4K
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…	730	$40	$29K

Showing 1–10 of 13

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

Stillaguamish Tribe Of Indians — 3 of 13 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

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	1	650	4,110	$250	$4.9M
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	5	60	18,030	$10	$4.1M
H0004	Behavioral health counseling and therapy, per 15 minutes	13	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…	62	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…	542	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…	888	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…	479	930	680	$60	$259.2K
H0038	Self‑help/peer services, per 15 minutes	72	130	990	$30	$192.6K
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…	68	230	3,070	$20	$135.6K
96153	N/A	43	210	2,910	$20	$105.2K

Showing 1–10 of 13

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Stillaguamish Tribe Of Indians	WA	Community/Behavioral Health Agency	$0	$9.2M

Nearby Providers

Other providers in the same ZIP code as Stillaguamish Tribe Of Indians, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northwest Emergency Physicians LLC	WA	Emergency Medicine Physician	$0	$79.6M
Public Hospital Dist No 1 Skagit	WA	General Acute Care Hospital	$0	$17.2M
Holman Recovery Center	WA	Substance Abuse Rehabilitation Facility	$0	$7.9M
Beautiful Autism	WA	Mental Health Counselor	$0	$2.8M
Sight Partners Physicians, P.C.	WA	Ambulatory Surgical Clinic/Center	$325.2K	$126.8K
Trans-west Ambulance Service LLC	WA	Ambulance	$114.5K	$221.2K
Michael Banitt	WA	Ophthalmology Physician	$262.9K	$0
Jennifer Paek	WA	Dermatology Physician	$144.7K	$0
Aaron Brinklow	WA	Student in an Organized Health Care Education/Training Program	$85.6K	$0
Alden Campbell	WA	Family Medicine Physician	$81K	$0

Stillaguamish Tribe Of Indians — Billing Profile & Reimbursement Data

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Stillaguamish Tribe Of Indians — 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