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.

Debbie Foley (NPI 1134140924)

Field	Value
Entity Type	Individual
Organization	Debbie Foley
Address	12142 S Yukon Ave
City	Glenpool
State	OK
ZIP	74033
Taxonomy	Rheumatology Physician
NPI Enumerated	July 21, 2006

Payer Source	Total Paid
Medicare	$3.7M
Medicaid	$0

Key Findings

This provider’s Medicare footprint is the dominant payer relationship: lifetime Medicare revenue is $3.7M while there is no Medicaid billing on file, making the practice effectively single‑payer Medicare‑dependent for public reimbursement. The precomputed concentration metric shows the top 3 Medicare codes by revenue account for 69.5% of total Medicare revenue, underlining that a few high‑value services drive most of reported public revenue.

The CPT/HCPCS mix is characteristic of a rheumatology practice that operates an infusion/oncology-style administration capability: the top revenue drivers are biologic and monoclonal antibody infusions (J0129, J3262, J1602) and the profile also includes chemotherapy/infusion administration codes such as 96413 and 96401. This suggests the provider delivers regular in-office IV biologic therapies and can support multi-drug infusion sessions rather than exclusively performing office visits or procedures.

Revenue concentration is high and concentrated in a small set of injectable biologic agents: J0129 accounts for 29.8% of Medicare revenue, J3262 for 21.8%, and J1602 for 17.9% (the top 3 combine to 69.5%). That reliance on a few high-cost infused drugs creates operational dependence on infusion throughput and reimbursement for those specific agents.

Competitive standing on key infusion codes is strong versus national peers: J0129 ranks #33 of 1221 providers nationally (97th percentile; notably above typical national volume), J3262 ranks #14 of 618 providers nationally (98th percentile; notably above typical national volume), and J1602 ranks #16 of 1041 providers nationally (99th percentile; notably above typical national volume). These high ranks indicate the provider is a major national volume outlier for several rheumatologic biologics, consistent with significant infusion activity and market presence in these product lines.

There are notable statistical outliers outside the three leading biologics as well: 96413 is listed as an "extreme outlier, far above typical national volume" and ranks #28 of 7514 providers nationally (100th percentile), signaling unusually high chemotherapy/infusion administration relative to peers. Additionally, 99214 ranks #10090 of 479517 providers nationally (98th percentile; notably above typical national volume), which suggests a higher-than-typical volume of moderate-complexity established patient office visits supporting the infusion practice.

The absence of Medicaid billing on file indicates the provider does not participate meaningfully in Medicaid or has no recorded Medicaid claims, creating a concentrated payer mix that may affect patient access and contracting leverage with managed Medicaid plans. From an analytics and contracting perspective, this single‑payer public profile should prompt payers and partners to treat Medicare reimbursement changes and drug pricing policy as primary drivers of revenue risk.

The provider’s NPI was enumerated 2006-07-21 (~20 years ago), indicating long tenure and an established practice history. When combined with the high national ranks on multiple infusion and biologic codes, the tenure supports the interpretation of a well‑established infusion service line and likely durable referral relationships for rheumatologic biologic therapy delivery.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0129	Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	33,930	$30	$1.1M
J3262	Injection, tocilizumab, 1 mg	163,680	$10	$818.4K
J1602	Injection, golimumab, 1 mg, for intravenous use	67,300	$10	$673K
J0717	Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	70,800	$1	$283.2K
J0897	Injection, denosumab, 1 mg	13,140	$20	$236.5K
J9312	Injection, rituximab, 10 mg	2,990	$60	$188.4K
J3111	Injection, romosozumab-aqqg, 1 mg	22,470	$10	$179.8K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	1,250	$90	$117.4K
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…	1,050	$90	$91.5K
96401	The provider administers nonhormonal, antineoplastic chemotherapy drugs subcutaneously or intramuscularly to the patient.	590	$50	$30.4K

Showing 1–10 of 20

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Oklahoma Distribution

Debbie Foley — 3 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oklahoma

Full comparison — all codes billed, vs. state median

20 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	3	10	16,680	$30	$661.9K
J3262	2	10	82,050	$1	$432.8K
J1602	2	20	25,400	$10	$412.3K
J0717	3	10	60,800	$1	$255.6K
J9312	5	10	3,650	$60	$246.8K
J3111	8	20	22,470	$10	$216.7K
J0897	6	70	2,130	$20	$91.2K
96413	2	60	210	$90	$26.4K
99214	171	5,560	130	$70	$18.4K
96401	1	20	110	$50	$6.4K

Showing 1–10 of 20

Related Providers

Other providers that share a Tax Identification Number (TIN) with Debbie Foley, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chad Crawley	OK	Orthopaedic Surgery Physician	$262.9K	$0
Randall Hendricks	OK	Orthopaedic Surgery Physician	$157.8K	$0
Ronald Labutti	OK	Adult Reconstructive Orthopaedic Surgery Physician	$154.6K	$0
Bradley Lawson	OK	Orthopaedic Surgery Physician	$94.2K	$0
Jeff Fox	OK	Sports Medicine (Orthopaedic Surgery) Physician	$88.7K	$0
Blake Shockley	OK	Orthopaedic Surgery Physician	$69.9K	$0
Brent Nossaman	OK	Orthopaedic Surgery Physician	$37.4K	$0
Bryan Hawkins	OK	Orthopaedic Surgery Physician	$37.3K	$0
Molly Cook	OK	Hand Occupational Therapist	$23.8K	$0

Nearby Providers

Other providers in the same ZIP code as Debbie Foley, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chad Edwards	OK	Family Medicine Physician	$10.9K	$0

Debbie Foley — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References