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NPI 1972735157 · Lakewood, WA · Primary Care Clinic/Center
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Rainier Internal Medicine LLC is a primary care clinic/center provider located in Lakewood, Washington. This profile covers 1 Medicare and 36 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 | Rainier Internal Medicine LLC |
| Address | 9720 S Tacoma Way |
| City | Lakewood |
| State | WA |
| ZIP | 98499 |
| Taxonomy | Primary Care Clinic/Center |
| NPI Enumerated | August 20, 2009 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $35.1M |
| Medicare | $164.9K |
The provider's revenue footprint is overwhelmingly Medicaid-centric: Total Medicaid revenue is $35.1M compared with Total Medicare revenue of $164.9K, indicating the organization functions primarily as a Medicaid-serving practice rather than a Medicare-focused clinic. This scale difference makes the provider effectively Medicaid-dominant in payer mix and suggests business decisions and payer relations are likely driven by Medicaid reimbursement dynamics.
The code mix strongly indicates an operation centered on medication‑assisted treatment (MAT) and substance-use services. Medicare billing is concentrated entirely in G2067 (medication assisted treatment, methadone bundle), while Medicaid top codes include H0020 (methadone administration), 80307 (instrumented presumptive drug testing), and H0004 (behavioral health counseling), showing an integrated model of opioid agonist dispensing, frequent toxicology screening, and behavioral health support.
Medicare revenue is highly concentrated: the precomputed top-3 Medicare codes account for 100.0% of the provider's Medicare revenue, and that Medicare total of $164.9K is driven by G2067 (690 claims, $239 avg paid/claim, $164.9K revenue). G2067 ranks #382 of 830 providers nationally (54th percentile) and is labeled as typical, unremarkable volume, so the practice is a modest, not dominant, national participant in Medicare MAT billing.
On Medicaid the top three codes are responsible for a very large share of revenue — precomputed to be 90.8% — with H0020 at 69.0%, 80307 at 14.3%, and 99213 at 7.5% of Medicaid revenue. This concentration shows that a small set of service lines (methadone administration and related lab and outpatient E/M services) generate the bulk of the $35.1M Medicaid book.
The provider appears to be a major in-state supplier of methadone services: H0020 (1.2M claims, $21 avg paid/claim, $24.3M revenue) ranks #4 of 60 providers in-state (95th percentile) and is described as notably above typical state volume, signaling a prominent regional role in methadone dispensing. Several supportive codes also sit high in-state (for example, 80307 ranks #6 of 172, 97th percentile but described as typical, unremarkable volume), which together show high operational volumes for drug testing and related services.
Beyond methadone dispensing, the practice bills for conventional outpatient care and behavioral health that support a MAT program. Medicaid shows substantial volumes of 80307 (88.3K claims, $57 avg paid/claim, $5M revenue), 99213 (43K claims, $61 avg paid/claim, $2.6M revenue) and H0004 (27.8K claims, $42 avg paid/claim, $1.2M revenue), indicating routine E/M visits and counseling are sizable revenue contributors and likely part of an integrated treatment pathway.
The provider has an extended tenure in the public programs, with NPI enumeration on 2009-08-20 (~17 years ago), which together with the multi-million dollar Medicaid revenue suggests an established operating presence in the market. That longevity, coupled with concentrated Medicaid volumes, supports the inference of a stable, specialized clinic rather than a recently entered or transient operation.
The business is exposed to reimbursement or policy shifts concentrated on methadone and drug-testing codes because a small set of codes produce the majority of revenue across payers. Given the precomputed concentration (Medicare top‑3 = 100.0% of Medicare revenue; Medicaid top‑3 = 90.8% of Medicaid revenue) any changes to payment rules, program eligibility, or utilization management for H0020, G2067, or 80307 would materially affect overall revenue and operational planning.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| G2067 | Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed… | 690 | $240 | $164.9K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 1 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
1 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| G2067 | 10 | 20 | 690 | $220 | $226.1K |
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
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Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
36 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | 1,157,720 | $20 | $24.3M |
| 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. | 88,330 | $60 | $5M |
| 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… | 43,040 | $60 | $2.6M |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 27,750 | $40 | $1.2M |
| 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… | 7,760 | $80 | $651.4K |
| 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… | 3,970 | $130 | $512.4K |
| J0574 | Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine | 39,250 | $10 | $196.3K |
| 99204 | The provider sees a new 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 provider… | 1,530 | $130 | $195.5K |
| 96153 | N/A | 14,910 | $10 | $193.8K |
| H0001 | Alcohol and/or drug assessment | 1,420 | $60 | $89.5K |
Showing 1–10 of 36
How this provider's Medicaid billing volume and revenue compare to other Washington providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Washington median
36 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | 4 | 60 | 18,030 | $10 | $4.1M |
| 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. | 6 | 170 | 2,120 | $40 | $779.1K |
| H0004 | Behavioral health counseling and therapy, per 15 minutes | 23 | 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… | 138 | 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… | 238 | 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… | 71 | 1,860 | 610 | $40 | $295.5K |
| H0038 | Self‑help/peer services, per 15 minutes | 120 | 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… | 137 | 230 | 3,070 | $20 | $135.6K |
| 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… | 33 | 540 | 130 | $90 | $128.6K |
| 96153 | N/A | 23 | 210 | 2,910 | $20 | $105.2K |
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Other providers in the same ZIP code as Rainier Internal Medicine LLC, ranked by combined Medicare and Medicaid revenue.
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