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.

Gwen Fuentes Md Pediatric Clinic (NPI 1083830608)

Gwen Fuentes Md Pediatric Clinic is a medical specialty clinic/center provider located in Ardmore, Oklahoma. This profile covers 0 Medicare and 52 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	Gwen Fuentes Md Pediatric Clinic
Address	919 15th Ave Nw
City	Ardmore
State	OK
ZIP	73401
Taxonomy	Medical Specialty Clinic/Center
NPI Enumerated	April 18, 2007

Payer Source	Total Paid
Medicaid	$1.9M
Medicare	$0

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

52 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…	7,800	$70	$569.3K
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.	5,230	$40	$182.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,910	$90	$175.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1,580	$100	$161.2K
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…	1,680	$90	$156.4K
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,…	3,600	$40	$140.6K
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…	1,210	$110	$136.2K
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…	1,480	$90	$129K
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.	4,700	$10	$65.7K
92567	In this procedure, the provider measures the functioning of the middle ear by varying the pressure of air presented to the ear to identify the reason for hearing loss.	2,080	$10	$29.1K

Showing 1–10 of 52

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

Gwen Fuentes Md Pediatric Clinic — 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

52 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,…	38	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…	711	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…	207	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…	75	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…	64	280	470	$100	$140.8K
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.	22	210	350	$40	$73.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	29	290	200	$90	$72.1K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	149	290	260	$40	$69.7K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	35	110	170	$40	$50.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	15	270	90	$100	$35.5K

Showing 1–10 of 52

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chickasaw Nation Division Of Health	OK	Primary Care Clinic/Center	$0	$30.6M
Mercy Hospital Ardmore, Inc.	OK	General Acute Care Hospital	$0	$18.1M
Lighthouse Behavioral Wellness Centers	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$9.3M
Lighthouse Behavioral Wellness Centers	OK	Community/Behavioral Health Agency	$0	$7.6M
Good Shepherd Community Clinic, Inc.	OK	Federally Qualified Health Center (FQHC)	$0	$6M
Southern Oklahoma Ambulance Service, Inc.	OK	Land Ambulance	$1.1M	$3.5M
Lynch Family Services LLC	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$4.5M
Scott Cooper	OK	Medical Physician Assistant	$4.4M	$0
Lighthouse Behavioral Wellness Centers	OK	Community/Behavioral Health Agency	$0	$4.2M
Family Practice Associates	OK	Family Medicine Physician	$0	$4.2M

Gwen Fuentes Md Pediatric Clinic — 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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