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.

South Pointe Pediatrics, PLLC (NPI 1235399122)

South Pointe Pediatrics, PLLC is a pediatric adolescent medicine physician provider located in Broken Arrow, Oklahoma. This profile covers 0 Medicare and 35 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	South Pointe Pediatrics, PLLC
Address	1615 S Eucalyptus Ave
City	Broken Arrow
State	OK
ZIP	74012
Taxonomy	Pediatric Adolescent Medicine Physician
NPI Enumerated	June 13, 2008

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.

35 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…	9,450	$70	$680K
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…	3,360	$100	$319.3K
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…	2,690	$90	$247.5K
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…	2,830	$90	$246.5K
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.	5,710	$40	$228.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	690	$90	$62.2K
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,…	640	$50	$30.5K
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.	680	$30	$19.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	100	$100	$10.1K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	200	$50	$9.4K

Showing 1–10 of 35

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

South Pointe Pediatrics, PLLC — 0 of 22 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

35 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,…	130	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…	354	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…	171	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…	39	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…	37	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…	104	160	130	$90	$84.6K
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.	18	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.	53	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.	71	290	200	$90	$72.1K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	97	110	160	$80	$69.9K

Showing 1–10 of 35

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Collaborative Therapy Services Inc	OK	Multi-Specialty Clinic/Center	$0	$12.9M
Family Smiles Dentistry, PLLC	OK	General Practice Dentistry	$0	$10.8M
Eastern Oklahoma Oral And Maxillofacial Surgeons	OK	Oral and Maxillofacial Surgery (Dentist)	$0	$8.3M
Stonewood Hills Oral Maxillofacial Surgery, Inc.	OK	Oral and Maxillofacial Surgery (Dentist)	$0	$6.5M
Eton Home Healthcare, Inc.	OK	Home Health Agency	$0	$5.6M
Brighter Dimensions, LLC	OK	Community/Behavioral Health Agency	$0	$5M
City Of Broken Arrow	OK	Land Ambulance	$1.2M	$2.4M
Dental Depot Of Broken Arrow, PLLC	OK	Dentist	$0	$3.2M
The Griffin Promise	OK	Speech-Language Pathologist	$0	$3.2M
Pmo Medical PLLC	OK	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$0	$3.1M

South Pointe Pediatrics, PLLC — Billing Profile & Reimbursement Data

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South Pointe Pediatrics, 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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