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.

Summit Medical Center (NPI 1356574560)

Field	Value
Entity Type	Organization
Organization	Summit Medical Center
Address	1800 S. Renaissance Blvd.
City	Edmond
State	OK
ZIP	73013
Taxonomy	General Acute Care Hospital
NPI Enumerated	September 3, 2009

Payer Source	Total Paid
Medicaid	$7.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D9999	N/A	3,360	$940	$3.1M
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	510	$3,110	$1.6M
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	3,300	$440	$1.5M
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	1,000	$560	$560.9K
67311	The provider realigns an imbalance in the eye muscles by either recession, which weakens the eye muscle or resection, which strengthens the muscles so as to restore normal vision. This procedure is…	100	$1,240	$128K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	360	$340	$124.5K
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,…	1,320	$50	$59.4K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	330	$100	$32.9K
62369	The provider analyzes performance of an implantable pump and also reprograms the pump and refills it. Intrathecal or epidural pumps may be used to deliver pain medications to patients suffering from…	240	$90	$20.5K
42830	The provider performs an initial adenoidectomy in a patient who is less than 12 years old.	10	$1,270	$15.2K

Showing 1–10 of 13

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

Summit Medical Center — 3 of 10 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

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D9999	N/A	3	40	310	$690	$591.7K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	10	50	70	$1,800	$496.5K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	2	70	150	$450	$279K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	28	50	330	$80	$238.7K
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	1	10	500	$330	$146.5K
J3490	Unclassified drugs	6	20	100	$40	$90.2K
42830	The provider performs an initial adenoidectomy in a patient who is less than 12 years old.	12	10	80	$730	$85.5K
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,…	58	290	260	$40	$69.7K
67311	The provider realigns an imbalance in the eye muscles by either recession, which weakens the eye muscle or resection, which strengthens the muscles so as to restore normal vision. This procedure is…	2	10	70	$790	$66.2K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	8	20	240	$190	$62.3K

Showing 1–10 of 13

Nearby Providers

Other providers in the same ZIP code as Summit Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Specialty Care Pediatrics, Inc.	OK	Home Health Agency	$0	$44.8M
Medical Resource Management, LLC	OK	Urgent Care Clinic/Center	$0	$14.9M
Oklahoma Arthritis Center, P.C.	OK	Rheumatology Physician	$0	$10.1M
Craig Carson	OK	Rheumatology Physician	$9.7M	$0
Sand Lily Healthcare, Inc.	OK	In Home Supportive Care Agency	$0	$8.9M
Christopher Fisher	OK	Internal Medicine Physician	$7.6M	$0
Brian Phelps	OK	Retina Specialist (Ophthalmology) Physician	$4.1M	$0
Ana Kumar	OK	Rheumatology Physician	$4.1M	$0
Sandeep Shah	OK	Retina Specialist (Ophthalmology) Physician	$3.9M	$0
Ryan Ridges	OK	Retina Specialist (Ophthalmology) Physician	$3.6M	$0

Summit Medical Center — Billing Profile & Reimbursement Data

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Summit Medical Center — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References