Stillaguamish Tribe of Indians
High Cost Per Claim
Average payment per claim is much higher than peers billing the same procedures.
High Claims Per Patient
Filing an unusually high number of claims per beneficiary compared to peers.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
▼
Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
High Cost Per Claim
High Cost Per Claim means each individual claim from this provider costs significantly more than what other providers charge for the same services. This could indicate upcoding (billing for more expensive services than provided) or legitimate specialized care.
High Claims Per Patient
High Claims Per Patient means this provider files an unusually high number of claims per individual patient. This could indicate legitimate intensive treatment or a pattern of billing for services not actually rendered.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Risk Assessment
Bills $32.35 per claim for 96153 (Health/behavior intervention, group) — 4.8× the national median of $6.67.
This is a statistical summary, not an accusation. See our methodology.
Compared to Clinic/Center Rehabilitation Substance Use Disorder Peers
Total spending distribution among 8 providers in this specialty
This provider's total spending of $349.3M is at the 75th percentile among 8 Clinic/Center Rehabilitation Substance Use Disorder providers.
Total Paid
$349.3M
$349,263,533
Total Claims
2.0M
Beneficiaries
167K
11.8 claims/patient
Avg Cost/Claim
$178
#197 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Stillaguamish Tribe of Indians is a Clinic/Center Rehabilitation Substance Use Disorder provider based in Arlington, WA. From the 2018–2024 period, this provider received $349.3M in Medicaid payments across 2.0M claims.
Why This Matters
This provider received $349.3M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 43,657 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 13 distinct procedure codes. The top code (T1015 (Clinic visit/encounter, all-inclusive)) accounts for 96% of total spending.
$333.8M
946K claims
$352.84
$121.16
Clinic visit/encounter, all-inclusive
$333.8M
946K claims · 95.6%
$13.0M
939K claims
$13.81
$18.95
Alcohol/drug services; methadone administration
$13.0M
939K claims · 3.7%
$1.6M
44K claims
$35.55
$74.63
Behavioral health counseling & therapy, per 15 min
$1.6M
44K claims · 0.4%
$277K
8K claims · 0.1%
Health/behavior intervention, group
$262K
8K claims · 0.1%
$139K
8K claims
$16.41
$15.54
Health behavior intervention, family, each additional fifteen minutes
$139K
8K claims · 0.0%
$102K
2K claims
$56.53
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$102K
2K claims · 0.0%
$60K
8K claims · 0.0%
Psychotherapy, 60 minutes
$56K
656 claims · 0.0%
$29K
725 claims
$39.56
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$29K
725 claims · 0.0%
$12K
727 claims
$17.03
$55.04
Self-help/peer services, per 15 minutes
$12K
727 claims · 0.0%
Alcohol and/or drug assessment
$10K
476 claims · 0.0%
$459
61 claims
$7.53
$9.70
Electrocardiogram, complete, with interpretation and report
$459
61 claims · 0.0%
Other Top Providers in Washington
View all →We Care Daily Clinics LLC
Clinic/Center Methadone Clinic
$260.6M
Ideal Option, PLLC
Preventive Medicine, Addiction Medicine
$259.1M
Seattle Children's Hospital
Prosthetic/Orthotic Supplier
$219.5M
Swinomish Health Services
Clinic/Center Rehabilitation Substance Use Disor
$195.9M
Laboratory Corporation of America
Clinical Medical Laboratory
$186.7M
Similar Providers
Other top providers in Clinic/Center Rehabilitation Substance Use Disorder