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.

Northern Oklahoma Regional Pediatric Clinic, PLLC (NPI 1053486431)

Northern Oklahoma Regional Pediatric Clinic, PLLC is a pediatric adolescent medicine physician provider located in Ponca City, Oklahoma. This profile covers 0 Medicare and 57 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	Northern Oklahoma Regional Pediatric Clinic, PLLC
Address	415 Fairview Ave
City	Ponca City
State	OK
ZIP	74601
Taxonomy	Pediatric Adolescent Medicine Physician
NPI Enumerated	November 21, 2006

Payer Source	Total Paid
Medicaid	$10.8M
Medicare	$0

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

57 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	44,950	$100	$4.5M
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…	20,890	$70	$1.4M
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…	11,610	$90	$1.1M
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…	10,270	$90	$893.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	6,510	$90	$599.2K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	12,670	$40	$544.7K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	17,750	$20	$319.6K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,410	$100	$245.5K
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.	13,170	$10	$184.4K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	25,130	$10	$175.9K

Showing 1–10 of 57

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

Northern Oklahoma Regional Pediatric Clinic, PLLC — 15 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

57 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,…	221	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…	17	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…	58	1,750	870	$70	$254.4K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	258	280	840	$50	$179.5K
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…	10	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…	5	280	470	$100	$140.8K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	174	190	80	$200	$128K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	60	300	100	$150	$79.5K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	21	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.	6	290	200	$90	$72.1K

Showing 1–10 of 57

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grand Lake Mental Health Center Inc	OK	Community/Behavioral Health Agency	$0	$15.4M
Kay County Oklahoma Hospital Company LLC	OK	General Acute Care Hospital	$0	$6.8M
Amc Urgent Care Plus, LLC	OK	General Practice Physician	$0	$5.3M
Nes Oklahoma, Inc.	OK	Emergency Medicine Physician	$0	$4.6M
Grand Lake Mental Health Center, Inc.	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$4.1M
Ponca City Immediate Care, LLC	OK	Family Medicine Physician	$0	$3.8M
White Eagle Health Center	OK	Clinic/Center	$0	$2.4M
City Of Ponca City	OK	Land Ambulance	$489.1K	$1.6M
Kay County Oklahoma Hospital Company LLC	OK	Rural Health Clinic/Center	$0	$1.8M
Air Evac Ems, Inc.	OK	Air Ambulance	$730.3K	$84.4K

Northern Oklahoma Regional Pediatric Clinic, PLLC — Billing Profile & Reimbursement Data

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Northern Oklahoma Regional Pediatric Clinic, PLLC — 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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