Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Oklahoma for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Oklahoma only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Oklahoma (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Franz Moncada Md Inc (NPI 1033272281)

Franz Moncada Md Inc is a pediatrics physician provider located in Tulsa, Oklahoma. This profile covers 0 Medicare and 48 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Franz Moncada Md Inc
Address	6465 S Yale Ave
City	Tulsa
State	OK
ZIP	74136
Taxonomy	Pediatrics Physician
NPI Enumerated	December 19, 2006

Payer Source	Total Paid
Medicaid	$2.1M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

48 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	6,040	$70	$440.7K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	3,120	$90	$290.3K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	7,360	$40	$287.1K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	3,110	$90	$267.8K
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…	2,720	$100	$266.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2,210	$90	$203.1K
92587	Code 92587 is in the Medicine/Special Otorhinolaryngologic Services Section. It involves special procedures of the ears/nose/throat. This code is for screening purposes with interpretation and…	3,260	$20	$65.2K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	1,950	$30	$56.7K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	520	$100	$52.2K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	2,260	$10	$31.6K

Showing 1–10 of 48

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Oklahoma providers billing the same CPT/HCPCS codes.

Claims Volume vs. Oklahoma Distribution

Franz Moncada Md Inc — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oklahoma

Full comparison — all codes billed, vs. Oklahoma median

48 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	273	530	140	$450	$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…	427	1,680	820	$90	$307K
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…	266	1,750	870	$70	$254.4K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	38	270	600	$90	$159.1K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	30	280	470	$100	$140.8K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	50	160	130	$90	$84.6K
99203	The provider sees a new 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 provider…	545	710	140	$100	$74.6K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	14	210	350	$40	$73.2K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	27	90	100	$120	$73K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	24	290	200	$90	$72.1K

Showing 1–10 of 48

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saint Francis Hospital, Inc.	OK	General Acute Care Hospital	$0	$43.2M
Warren Clinic Inc	OK	General Practice Physician	$0	$40.2M
Specialized Home Nursing, Inc.	OK	Home Health Agency	$0	$21.5M
Saint Francis Outreach Services LLC	OK	Clinical Medical Laboratory	$5.4M	$15.7M
Improving Lives Counseling Services, Inc.	OK	Community/Behavioral Health Agency	$0	$21.1M
Preferred Family Health Care, Inc.	OK	Community/Behavioral Health Agency	$0	$19.4M
Osu Center For Health Sciences	OK	Medical Specialty Clinic/Center	$0	$18.9M
Emergency Medicine Physicians Of Tulsa County, LLC	OK	Emergency Medicine Physician	$0	$18M
Osu Center For Health Sciences	OK	Medical Specialty Clinic/Center	$0	$14.1M
Home Therapy Resources, Inc.	OK	Pediatric Physical Therapist	$0	$9.4M

Franz Moncada Md Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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