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.

Ahs Oklahoma Physician Group LLC (NPI 1235182775)

Key Findings

Field	Value
Entity Type	Organization
Organization	Ahs Oklahoma Physician Group LLC
Address	1120 S Utica Ave Ste 100
City	Tulsa
State	OK
ZIP	74104
Taxonomy	Family Medicine Physician
NPI Enumerated	May 18, 2006

Payer Source	Total Paid
Medicaid	$17.4M
Medicare	$0

AHS OKLAHOMA PHYSICIAN GROUP LLC appears to be effectively single‑payer in the available data: there is no Medicare billing on file while Medicaid revenue totals $17.4M. The provider’s NPI was enumerated on 2006-05-18 (~20 years ago), indicating a long-tenured presence in Tulsa that has generated the reported Medicaid activity over time.

Revenue is highly concentrated in a small set of outpatient E/M and preventive codes: the top three Medicaid codes (99213, 99214, 99391) account for 64.1% of the provider’s total Medicaid revenue. Those individual contributions are large in absolute terms (99213: 83.1K claims, $61 avg paid/claim, $5.1M revenue; 99214: 63.9K claims, $68 avg paid/claim, $4.3M revenue; 99391: 12.4K claims, $87 avg paid/claim, $1.1M revenue), showing reliance on routine office and preventive visits.

The code mix is consistent with a high-volume family medicine/primary care practice that also delivers substantial pediatric preventive services and immunizations. High counts for E/M established visit codes (99213 and 99214), preventive medicine codes (99391, 99392, 99393, 99394), and vaccine administration codes (90460, 90471, 90472) point to a practice focused on routine ambulatory care, well‑child visits, and immunization delivery.

For key E/M codes the provider is a dominant statewide participant: 99213 ranks #8 of 1746 providers in-state and is flagged as a 100th percentile, extreme outlier, far above typical state volume for this code, while 99214 ranks #11 of 1680 providers and is a 99th percentile extreme outlier. These rank/percentile descriptors indicate the practice operates at volumes for established primary care visits that are far above typical in Oklahoma.

Preventive and vaccination services also show above-typical statewide volume: 99391 ranks #6 of 273 providers (98th percentile; notably above typical state volume), 99392 ranks #8 of 283 (98th percentile; notably above typical), and 90460 ranks #6 of 207 (98th percentile; notably above typical state volume). Several additional preventive and adolescent well-visit codes (99393, 99394) and vaccine administration codes (90471, 90472) are likewise in high percentiles, reinforcing a strong focus on pediatric and preventive care.

The practice also bills for hospital and higher-acuity services, but at lower scale relative to its ambulatory volume: examples include 99222 (3.5K claims, $314K revenue; ranks #9 of 124, 93rd percentile), 99291 critical care (1.5K claims, $225.6K revenue; ranks #9 of 55, 85th percentile), and the obstetric global 59400 (219 claims, $350.2K revenue; ranks #12 of 38, 70th percentile). These data suggest some inpatient/acute care capability or affiliations, but that line of business is secondary to ambulatory primary care and preventive services.

Payment-per-service patterns show modest Medicaid E/M reimbursements on high-volume visits (e.g., 99213 at $61 avg paid/claim and 99214 at $68 avg paid/claim) while certain procedure codes produce higher per-claim payments (e.g., J0585 at $377 avg paid/claim across 294 claims). This mix implies operational scale is driven by high visit volumes rather than high per-encounter reimbursement.

Business risk and operational implications: with 64.1% of Medicaid revenue concentrated in three codes and no Medicare revenue on file, the provider’s financial performance is highly dependent on maintaining large volumes of routine E/M and preventive visits within Medicaid. The long tenure (~20 years) and dominant state-level volumes for core primary care codes suggest entrenched market position in Medicaid, but the single-payer concentration could pose exposure to Medicaid policy or reimbursement changes.

Medicaid: Complete Services Breakdown

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

164 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…	83,140	$60	$5.1M
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…	63,890	$70	$4.3M
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…	12,380	$90	$1.1M
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…	9,960	$90	$915.9K
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.	12,450	$40	$510.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5,280	$90	$480.2K
99204	The provider sees a new 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 provider…	4,170	$110	$467K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	6,640	$60	$418.1K
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	220	$1,600	$350.2K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	3,450	$90	$314K

Showing 1–10 of 164

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

Ahs Oklahoma Physician Group LLC — 14 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

164 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	123	230	1,440	$170	$1.2M
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,…	45	530	140	$450	$1.2M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	240	250	1,820	$130	$1.1M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	125	180	1,030	$200	$1M
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	27	50	70	$1,800	$496.5K
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	12	40	60	$2,350	$476.3K
95819	Electroencephalogram or EEG is a diagnostic test that uses small electrodes attached to the scalp to measure the electrical activity of the brain. In this procedure the provider performs the EEG…	9	10	510	$370	$362.5K
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…	11	1,680	820	$90	$307K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	50	70	150	$450	$279K
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…	8	1,750	870	$70	$254.4K

Showing 1–10 of 164

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ahs Claremore Regional Hospital, LLC.	OK	General Acute Care Hospital	$0	$4.8M
Ahs Claremore Regional Hospital, LLC	OK	Rural Health Clinic/Center	$0	$2.4M
Ahs Oklahoma Physician Group, LLC	OK	Rural Health Clinic/Center	$0	$2.1M
Tyler Woods	OK	Family Nurse Practitioner	$878.4K	$0
Khalid Aly	OK	Internal Medicine Physician	$718.2K	$0
Joseph Womack	TX	Urology Physician	$463.6K	$0
David Sandler	OK	Clinical Cardiac Electrophysiology Physician	$397.7K	$0
Jaclyn Duvall	OK	Neurology Physician	$354.7K	$0
Isaiah Wilson	OK	Physical Medicine & Rehabilitation Physician	$301.5K	$0
Andreas Revelis	OK	Pain Medicine (Anesthesiology) Physician	$285K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Green Country Emergency Physicians Group Of Tulsa PLLC	OK	Emergency Medicine Physician	$0	$18.9M
St. John Physicians, Inc.	OK	Internal Medicine Physician	$0	$17.7M
Ahs Hillcrest Medical Center, LLC	OK	General Acute Care Hospital	$0	$14.4M
Osu Center For Health Sciences	OK	Medical Specialty Clinic/Center	$0	$8.5M
Oklahoma State University	OK	Medical Specialty Clinic/Center	$0	$8.2M
Mbc Dental	OK	General Practice Dentistry	$0	$7.4M
Osu Center For Health Sciences	OK	Clinic/Center	$0	$6.4M
Community Health Connection, Inc.	OK	Federally Qualified Health Center (FQHC)	$0	$6.4M
Tulsa Hospitalists Inc	OK	Internal Medicine Physician	$0	$5.6M
St John Medical Center Inc	OK	General Acute Care Hospital	$0	$5.3M

Ahs Oklahoma Physician Group LLC — Billing Profile & Reimbursement Data

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Ahs Oklahoma Physician Group LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References