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.

Saint Medical Group, LLC (NPI 1306447172)

Saint Medical Group, LLC is a family medicine physician provider located in Shawnee, Oklahoma. This profile covers 0 Medicare and 43 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	Saint Medical Group, LLC
Address	4651 N Harrison
City	Shawnee
State	OK
ZIP	74804
Taxonomy	Family Medicine Physician
NPI Enumerated	November 6, 2020

Payer Source	Total Paid
Medicaid	$4.5M
Medicare	$0

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

43 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…	16,630	$100	$1.7M
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…	560	$1,890	$1.1M
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…	7,860	$70	$573.7K
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,…	7,090	$40	$255.3K
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.	7,380	$30	$206.7K
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.	9,670	$20	$145K
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…	800	$140	$110.9K
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…	1,050	$90	$91.3K
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…	650	$90	$60.4K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	1,270	$40	$47.1K

Showing 1–10 of 43

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

Saint Medical Group, LLC — 4 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

43 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	17	20	580	$140	$627K
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…	5	40	60	$2,350	$476.3K
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…	53	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…	203	1,750	870	$70	$254.4K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	11	20	360	$120	$199.8K
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…	103	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…	121	280	470	$100	$140.8K
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…	128	720	120	$150	$94.5K
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…	84	160	130	$90	$84.6K
99203	The provider sees a new 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 provider…	220	710	140	$100	$74.6K

Showing 1–10 of 43

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saints Medical Group, LLC	OK	Internal Medicine Physician	$0	$14.5M
Saints Medical Group, LLC	OK	Family Medicine Physician	$0	$1.6M
Clifford Henderson	OK	Dermatology Physician	$1.2M	$0
Tiffani Lowell	OK	Family Nurse Practitioner	$1.1M	$0
Jessica Graves	OK	Medical Physician Assistant	$859.2K	$0
Terry Hermance	OK	Family Medicine Physician	$768.1K	$0
Roy Rindler	OK	Dermatology Physician	$674.3K	$0
Asim Chohan	OK	Cardiovascular Disease Physician	$564.9K	$0
Corey Ponder	OK	Adult Reconstructive Orthopaedic Surgery Physician	$420.7K	$0
Mubina Gaffar	CA	Pulmonary Disease Physician	$364.6K	$19.2K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Anthony Shawnee Hospital Inc	OK	General Acute Care Hospital	$0	$23M
Citizen Potawatomi Nation	OK	Federally Qualified Health Center (FQHC)	$0	$8.6M
React Emergency Medical Service	OK	Land Ambulance	$1.3M	$6.4M
Advance Physicians Group	OK	Urgent Care Clinic/Center	$0	$7M
Hope Revealed Behavioral Health Center	OK	Community/Behavioral Health Agency	$0	$4.6M
Ocean Dental, PC	OK	General Practice Dentistry	$0	$4M
Summer Dental Shawnee PLLC	OK	Dentist	$0	$2.6M
Foundations Therapy, PLLC	OK	Pediatric Occupational Therapist	$0	$2M
Eric Reding	OK	Dermatology Physician	$261.7K	$0
Venkata Rama Gopala Damera	OK	Nephrology Physician	$217.5K	$0

Saint Medical Group, LLC — 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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