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NPI 1942253521 · Shawnee, OK · Multi-Specialty Clinic/Center
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Absentee Shawnee Tribal Health Authority, Inc. is a multi-specialty clinic/center provider located in Shawnee, Oklahoma. This profile covers 0 Medicare and 1 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Absentee Shawnee Tribal Health Authority, Inc. |
| Address | 2029 Gordon Cooper Dr |
| City | Shawnee |
| State | OK |
| ZIP | 74801 |
| Taxonomy | Multi-Specialty Clinic/Center |
| NPI Enumerated | May 18, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $15.8M |
| Medicare | $0 |
This provider is effectively single-payer in the claims dataset: there is no Medicare billing on file and all reported lifetime revenue is Medicaid-based, totaling $15.8M. The absence of Medicare billing is explicit in the source (“none below — this provider has no Medicare billing on file”), so analyses should treat ABSENTEE SHAWNEE TRIBAL HEALTH AUTHORITY, INC. as Medicaid-dependent for the observed period.
Revenue is highly concentrated in a single code line: T1015 (Clinic visit/encounter, all-inclusive) accounts for $15.8M and 100.0% of the provider's Medicaid revenue, with 27.3K claims and a $581 avg paid/claim. That concentration means overall Medicaid revenue performance will track very closely to volume, mix, and reimbursement dynamics for T1015 encounters.
The code mix — dominated entirely by T1015 — implies an operational model built around bundled clinic visits rather than fee-for-service procedure volumes. As a Multi-Specialty Clinic/Center billing primarily under a clinic visit/encounter code, the provider likely delivers broad ambulatory services and packages many visit components into a single encounter payment rather than generating diversified CPT procedure revenue.
Competitive standing on the primary revenue code is modest within the state: T1015 revenue for this provider ranks #26 of 143 providers in-state (82th percentile; typical, unremarkable volume for this code). That ranking indicates the provider is a meaningful in-state participant on this line but is not an outlier or market leader on T1015 encounters.
The concentration of 100.0% of Medicaid revenue into the top-3 codes (as precomputed) — effectively a single code in this file — creates financial sensitivity to policy or rate changes affecting clinic-encounter payments. Any state Medicaid reimbursement change for T1015 or administrative reclassification of bundled clinic payments would have a direct and immediate impact on the provider’s entire reported revenue base.
Operational and analytic monitoring should focus on encounter-level activity: given 27.3K T1015 claims at a $581 avg paid/claim, small changes in average paid/claim or claim counts will materially shift revenue. Analysts should track monthly claim volume, average paid/claim trends, and state policy updates for clinic/encounter billing to anticipate revenue movement.
The provider has a long tenure in the NPI registry, enumerated 2006-05-18 (~20 years ago), suggesting an established presence in the community and continuity of operations that could support steady Medicaid activity. Tenure supports interpreting the T1015 concentration as an operational choice or a stable patient-mix outcome rather than a transient reporting anomaly.
Although total Medicaid revenue of $15.8M is material, the dataset’s labeling of the provider’s T1015 volume as “typical, unremarkable” means this is not a statistical outlier on encounter volumes; the provider’s scale on T1015 is consistent with many peer clinics in-state rather than uniquely large. Consequently, competitive moves or reimbursement shifts by larger peers could change relative positioning without necessarily indicating atypical internal performance.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 27,260 | $580 | $15.8M |
How this provider's Medicaid billing volume and revenue compare to other Oklahoma providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Oklahoma median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 26 | 140 | 7,150 | $220 | $4.4M |
Other providers in the same ZIP code as Absentee Shawnee Tribal Health Authority, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Citizen Potawatomi Nation | OK | Federally Qualified Health Center (FQHC) | $0 | $15.7M |
| Oklahoma Mental Health Council | OK | Community/Behavioral Health Agency | $0 | $13M |
| Focus Mental Health Services, LLC | OK | Mental Health Counselor | $0 | $4.7M |
| Creoks Mental Health Services | OK | Community/Behavioral Health Agency | $0 | $3.4M |
| Community Health Centers, Inc. | OK | Federally Qualified Health Center (FQHC) | $0 | $2.7M |
| Anastasia Fisher | OK | Emergency Medicine Physician | $85.1K | $0 |
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