Clinic
SHC Medical Center Toppenish
SHC Medical Center Toppenish was paid $4.99M by Medicaid between Oct 2019 and Dec 2024, across 29 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 56% of everything it billed.
33Billing provider infoSHC MEDICAL CENTER TOPPENISH
UNION GAP, WA 98903
UNION GAP, WA 98903
33aNPI1013492784assigned 09/28/2018
33bProvider typeRural Health Clinic/Center
28Total paid$4.99M
24GClaims90,629
24DCodes billed29
24AFirst – last monthOct 2019 – Dec 2024
Compared with peers
Next to other Rural Health Clinic/Center providers in Washington
Rank by total paid#14 of 90
Median peer was paid$925K
This provider vs. median5.4×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official MATHIESEN, MATHEW controls 13+ related entities in our dataset. Read more
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 | |
|---|---|---|---|
| 2019 | 1,475 | $45K | |
| 2020 | 15,809 | $694K | |
| 2021 | 21,551 | $915K | |
| 2022 | 19,239 | $1.05M | |
| 2023 | 16,930 | $1.03M | |
| 2024incomplete | 15,625 | $1.26M |
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 | 56% | 43,799 | 38,931 | $2.80M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 22% | 23,555 | 20,898 | $1.10M |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 17% | 15,392 | 14,006 | $870K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 1.4% | 851 | 814 | $68K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.0% | 868 | 824 | $50K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | <1% | 552 | 522 | $39K |
| 99205 | Prolong outpt/office vis | <1% | 139 | 136 | $15K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 162 | 145 | $11K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 1,460 | 1,127 | $10K |
| 11721 | <1% | 163 | 156 | $9K | |
| 90686 | <1% | 567 | 547 | $7K | |
| 95251 | <1% | 394 | 371 | $3K |
17 more codes
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 544 | $2K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 26 | $2K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 271 | $1K |
| 76536 | <1% | 25 | $1K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 14 | $1K |
| 90670 | <1% | 58 | $622.74 | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 17 | $575.29 |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 67 | $561.24 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 69 | $529.38 |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 180 | $224.95 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 135 | $185.48 |
| 36415 | Collection of venous blood by venipuncture | <1% | 58 | $118.86 |
| 90633 | <1% | 15 | $53.16 | |
| 81002 | <1% | 27 | $44.66 | |
| G0008 | Administration of influenza virus vaccine | <1% | 19 | $38.34 |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 1,190 | $11.60 |
| 99406 | 0% | 12 | $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 officialMATHIESEN, MATHEW (CEO)
| Provider | Location | Paid |
|---|---|---|
| Sunnyside Community Hospital Association | Sunnyside, WA | $55.09M |
| SHC Medical Center Toppenish | Toppenish, WA | $15.10M |
| SHC Medical Center - Yakima | Yakima, WA | $6.93M |
| Sunnyside Community Hospital Association | Prosser, WA | $2.35M |
| SHC Medical Center Toppenish | Zillah, WA | $663K |
| SHC Medical Center Toppenish | Toppenish, WA | $381K |
| Sunnyside Community Hospital Association | Union Gap, WA | $316K |
| Sunnyside Community Hospital | Yakima, WA | $51K |
| SHC Medical Center - Yakima | Yakima, WA | $11K |
| Sunnyside Community Hospital | Sunnyside, WA | $4K |
| Sunnyside Community Hospital | Sunnyside, WA | $860.66 |
| Sunnyside Community Hospital Association | Yakima, WA | $839.86 |
| Sunnyside Community Hospital Association | Union Gap, WA | $696.97 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.