COWLITZ INDIAN TRIBE
NPI: 1164649679
· VANCOUVER, WA 98665
· General Practice Physician
· NPI assigned 04/19/2007
$3.88M
Total Medicaid Paid
Provider Details
| Authorized Official | KELLER, SHAVON (BILLING SUPERVISOR) |
| Parent Organization | COWLITZ INDIAN TRIBE |
| NPI Enumeration Date | 04/19/2007 |
Related Entities
Other providers sharing the same authorized official: KELLER, SHAVON
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
| 2018 |
2,825 |
$449K |
| 2019 |
3,867 |
$636K |
| 2020 |
1,757 |
$272K |
| 2021 |
4,227 |
$766K |
| 2022 |
4,035 |
$877K |
| 2023 |
2,433 |
$522K |
| 2024 |
1,587 |
$362K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic visit/encounter, all-inclusive |
9,175 |
1,622 |
$3.45M |
| 96153 |
|
2,534 |
433 |
$154K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
1,851 |
1,030 |
$127K |
| 96165 |
|
3,581 |
713 |
$116K |
| 96164 |
|
3,590 |
713 |
$39K |