Shoalwater Bay Indian Tribe

Shoalwater Bay Indian Tribe was paid $3.02M by Medicaid between Jan 2018 and Dec 2024, across 18 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 96% of everything it billed.

33Billing provider infoSHOALWATER BAY INDIAN TRIBE
TOKELAND, WA 98590

33aNPI1003028952assigned 05/04/2007

33bProvider typeDental Clinic/Center

28Total paid$3.02M

24GClaims12,636

24DCodes billed18

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Dental Clinic/Center providers in Washington

Rank by total paid#34 of 143

Median peer was paid$573K

This provider vs. median5.3×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2018	2,060	$480K
2019	2,442	$633K
2020	2,086	$393K
2021	1,595	$344K
2022	2,217	$516K
2023	1,565	$385K
2024incomplete	671	$269K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
T1015	A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive	96%	7,293	5,800	$2.89M
D0120	Dental checkup, returning patientPeriodic oral evaluation - established patient	<1%	870	860	$24K
D1110	Prophylaxis - adult	<1%	681	672	$24K
D1206	Topical application of fluoride varnish	<1%	1,411	1,389	$23K
D2391	Resin-based composite - one surface, posterior, primary or permanent	<1%	358	234	$17K
D2392	Resin-based composite - two surfaces, posterior, primary or permanent	<1%	174	141	$13K
D0274	Bitewings - four radiographic images	<1%	541	530	$7K
D0140	Limited oral evaluation - problem focused	<1%	299	280	$6K
D0220	Intraoral - periapical first radiographic image	<1%	558	534	$5K
D7140	Extraction, erupted tooth or exposed root	<1%	67	41	$2K
D1999		<1%	203	169	$2K
D4341		<1%	26	14	$1K

6 more codes

D0150	Comprehensive oral evaluation - new or established patient	<1%	50	$1K
D0330	Panoramic radiographic image	<1%	26	$851.46
D0210	Intraoral - complete series of radiographic images	<1%	13	$837.20
D9995		<1%	28	$160.00
D0270		<1%	25	$126.24
D0191		0%	13	$0.00

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialJOHNSON, CAROL (TRIBAL ADMINISTRATOR)

Same official

Other billing entities under JOHNSON, CAROL

Full network →

Provider	Location	Paid
Shoalwater Bay Indian Tribe	Tokeland, WA	$1.08M

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.