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.

St. John Physicians, Inc. (NPI 1336194406)

Key Findings

Field	Value
Entity Type	Organization
Organization	St. John Physicians, Inc.
Address	1923 S Utica Ave
City	Tulsa
State	OK
ZIP	74104
Taxonomy	Internal Medicine Physician
NPI Enumerated	May 24, 2006

Payer Source	Total Paid
Medicaid	$17.7M
Medicare	$0

This provider has no Medicare billing on file and is effectively a single‑payer Medicaid billing entity, reporting $17.7M in lifetime Medicaid revenue and no Medicare revenue. Analysts should treat Medicare‑level comparisons as inapplicable for this NPI and focus competitive analysis on Medicaid activity and in‑state peers.

Revenue concentration is high: the top three Medicaid codes (99214, 99213, 99284) together account for 57.0% of the provider’s total Medicaid revenue, indicating a reliance on a small set of E/M services for the majority of receipts. Those three codes individually generated $4.4M (25.6%), $2.7M (15.8%), and $2.7M (15.6%) respectively, so changes in reimbursement or utilization for these services would materially affect overall revenue.

The code mix and top revenue drivers point to a blended primary care and acute care operation: high volumes of 99214 (established outpatient visits) and 99213 signal heavy ambulatory primary care/office practice activity, while large revenues for 99284, 99283 and 99285 indicate substantial emergency department or urgent/evaluative care work. Presence of inpatient E/M codes (99233, 99232, 99223) and critical care code 99291 further suggests the provider bills across outpatient, ED, and inpatient settings rather than exclusively clinic visits.

Competitive standing for core outpatient primary care codes is exceptional in‑state: 99214 reports 52.9K claims, $83 avg paid/claim, $4.4M revenue and ranks #14 of 1680 providers in Oklahoma (99th percentile) and is described as an extreme outlier; 99213 reports 40.5K claims, $67 avg paid/claim, $2.7M revenue and ranks #23 of 1746 providers in Oklahoma (99th percentile) and is also an extreme outlier. These rankings indicate the provider is a dominant volume player for established office visits within the state.

Emergency service volumes are also significant but less uniquely dominant: 99284 generated 29.2K claims and $2.7M revenue and ranks #15 of 230 providers in‑state (94th percentile; characterized as typical), while 99283 (40K claims, $2.2M) ranks #11 of 254 (96th percentile; notably above typical). Together these ED/E&M codes represent a meaningful portion of activity but sit among a larger set of regional ED providers rather than as a single outlier.

The practice shows notable procedure and preventive service activity beyond visits: 93306 (echocardiography) generated 9.7K claims, $387.6K revenue and ranks #6 of 81 providers in‑state (94th percentile; notably above typical), and vaccination codes such as 90471 (12.4K claims, $223.7K revenue, rank #14 of 418, 97th percentile) and 90472 (6.7K claims, $242.5K revenue, rank #15 of 239, 94th percentile) indicate substantial immunization throughput. These patterns reinforce a mixed ambulatory clinic capability with on‑site diagnostics and preventive services.

Given the NPI was enumerated 2006-05-24 (~20 years ago), this is an established billing entity with long tenure in the market; longevity combined with extreme high percentile ranks on core office visit codes suggests sustained high-volume operations rather than a recent spike. Analysts should treat observed high volumes as persistent rather than transient without additional temporal data.

Because a majority of revenue is concentrated in a few E/M codes (top three = 57.0% of Medicaid revenue), the provider’s financial exposure to policy, reimbursement or utilization shifts for those specific codes is elevated. Coupled with the practically single‑payer Medicaid footprint, this concentration creates revenue sensitivity to state Medicaid policy and changes affecting outpatient and ED E/M reimbursement.

Medicaid: Complete Services Breakdown

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

130 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…	52,950	$80	$4.4M
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…	40,450	$70	$2.7M
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.	29,200	$90	$2.7M
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.	39,990	$60	$2.2M
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.	12,620	$110	$1.4M
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…	5,920	$90	$508.7K
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…	3,590	$120	$434K
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…	6,490	$70	$428.2K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	9,690	$40	$387.6K
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…	3,550	$90	$326.2K

Showing 1–10 of 130

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

St. John Physicians, Inc. — 6 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

130 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.	15	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,…	178	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.	11	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.	20	180	1,030	$200	$1M
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	47	50	70	$1,800	$496.5K
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…	14	1,680	820	$90	$307K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	61	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…	23	1,750	870	$70	$254.4K
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…	17	190	480	$70	$218.8K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	13	60	130	$210	$193.9K

Showing 1–10 of 130

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jane Phillips Memorial Medical Center, Inc.	OK	General Acute Care Hospital	$0	$6.8M
St John Urgent Care Clinics Inc	OK	Urgent Care Clinic/Center	$0	$5.1M
Anderson Mehrle	OK	Cardiovascular Disease Physician	$486.1K	$0
Vishal Aggarwal	OK	Internal Medicine Physician	$436.6K	$0
Donald Simmons	TX	Family Medicine Physician	$408.6K	$0
Samantha Kipps	OK	Family Nurse Practitioner	$388.4K	$0
Richard Holsopple	OK	Emergency Medicine Physician	$376.4K	$0
Kenneth Reed	OK	Pain Medicine (Anesthesiology) Physician	$371.6K	$0
David Remy	OK	Emergency Medicine Physician	$286.7K	$0
Faisal Latif	OK	Interventional Cardiology Physician	$274.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Green Country Emergency Physicians Group Of Tulsa PLLC	OK	Emergency Medicine Physician	$0	$18.9M
Ahs Oklahoma Physician Group LLC	OK	Family Medicine Physician	$0	$17.4M
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

St. John Physicians, Inc. — 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