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.

Northeastern Oklahoma Community Health Centers Inc (NPI 1376513002)

Field	Value
Entity Type	Organization
Organization	Northeastern Oklahoma Community Health Centers Inc
Address	1310 E Boone St
City	Tahlequah
State	OK
ZIP	74464
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	January 25, 2006

Payer Source	Total Paid
Medicaid	$16.6M
Medicare	$0

Key Findings

This provider effectively operates as a Medicaid-focused clinic: Medicare revenue is none (no Medicare billing on file) while lifetime Medicaid revenue totals $16.6M, indicating near-exclusive dependence on Medicaid for billed services. The NPI enumeration date is 2006-01-25 (~20 years ago), showing the organization has been active and established for roughly two decades.

Revenue is highly concentrated in a single encounter code: T1015 (Clinic visit/encounter, all-inclusive) generates $15.8M of the $16.6M Medicaid total and represents 95.1% of the provider’s Medicaid revenue; the precomputed top-3 codes together account for 98.8% of Medicaid revenue. This concentration means the provider’s financials are closely tied to reimbursement and utilization for that one encounter-based payment.

The code mix is consistent with an FQHC-style, encounter-based operating model: T1015’s dominance (83.5K claims) signals that the clinic is billing all-inclusive encounter payments typical for Federally Qualified Health Centers, while the presence of preventive visit codes (99391, 99392, 99393, 99394) and multiple vaccine administration codes (90471, 90472, 90460) indicates routine primary care, pediatric well visits, and immunization services are part of the service line. These preventive and vaccine codes are present at measurable volumes (for example, 99391: 3.3K claims; 90471: 1.7K claims), supporting a mixed primary care and pediatric/preventive scope.

Competitive standing for the dominant encounter code is strong in-state: T1015 ranks #6 of 143 providers in Oklahoma (96th percentile) and is described as notably above typical state volume for this code, positioning the provider as a major regional provider of encounter-based FQHC services. That rank, together with 83.5K T1015 claims, indicates high clinic utilization relative to other in-state FQHCs.

99213 appears as an unusually high-volume non-FQHC E/M code for this provider: 61.3K claims produced $551.7K revenue (3.3% of Medicaid revenue) and the provider ranks #13 of 1746 providers in-state (99th percentile), labeled an extreme outlier, far above typical state volume for this code. The coexistence of high-volume T1015 and high-volume 99213 billing suggests substantial use of both all-inclusive encounter billing and standard E/M coding streams, which should be reviewed for operational drivers (e.g., multiple practice locations, mixed billing arrangements, or administrative coding practices).

Most other billed services are modest and consistent with routine primary care: codes for pediatric well visits (99392, 99393, 99394), influenza and strep testing (87804, 87880), and vaccine administration (90471, 90472) appear at typical or unremarkable volumes and percentiles (for example, 99391 ranks #35 of 273, 88th percentile; 90472 ranks #87 of 239, 64th percentile), indicating the clinic delivers expected preventive and point-of-care testing services but these are not major revenue drivers.

From a risk and planning perspective, the organization’s heavy reliance on T1015 (95.1% of Medicaid revenue) and the top-3 concentration (98.8%) creates financial sensitivity to any Medicaid policy or rate changes affecting encounter-based FQHC payments. Even small changes to T1015 reimbursement or encounter eligibility could materially affect overall revenue given the narrow revenue base.

Operational scale and throughput are evident: 83.5K T1015 claims and 61.3K 99213 claims indicate high visit volumes, consistent with a busy community health center network. Combined with a ~20-year NPI tenure (2006-01-25), these data support the view that the organization is an established, high-volume Medicaid provider in its market, especially for encounter-based primary care services.

Medicaid: Complete Services Breakdown

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

26 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	83,530	$190	$15.8M
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…	61,300	$10	$551.7K
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…	3,290	$20	$59.1K
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…	2,800	$20	$56K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	1,660	$20	$28.2K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	940	$30	$28.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,350	$20	$24.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	710	$30	$17.9K
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.	3,720	$1	$14.9K
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.	6,790	$1	$6.8K

Showing 1–10 of 26

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

Northeastern Oklahoma Community Health Centers Inc — 3 of 21 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

26 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	6	140	7,150	$220	$4.4M
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,…	23	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…	1,175	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…	13	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…	35	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…	35	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…	125	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…	562	710	140	$100	$74.6K
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.	39	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.	68	90	100	$120	$73K

Showing 1–10 of 26

Related Providers

Other providers that share a Tax Identification Number (TIN) with Northeastern Oklahoma Community Health Centers Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northeastern Oklahoma Community Health Centers, Inc	OK	Federally Qualified Health Center (FQHC)	$0	$7M
Northeastern Oklahoma Community Health Centers, Inc	OK	Federally Qualified Health Center (FQHC)	$0	$5.8M
Northeastern Oklahoma Community Health Centers, Inc	OK	Federally Qualified Health Center (FQHC)	$0	$4.2M
Northeastern Oklahoma Community Health Centers Inc	OK	Federally Qualified Health Center (FQHC)	$0	$3.3M
Northeastern Oklahoma Community Health Centers, Inc	OK	Federally Qualified Health Center (FQHC)	$0	$3M
Northeastern Oklahoma Community Health Centers, Inc.	OK	Federally Qualified Health Center (FQHC)	$0	$2.6M
Northeastern Oklahoma Community Health Centers, Inc.	OK	Federally Qualified Health Center (FQHC)	$0	$2.6M
Northeastern Oklahoma Community Health Centers, Inc	OK	Federally Qualified Health Center (FQHC)	$0	$2.2M
Northeastern Oklahoma Community Health Centers, Inc.	OK	Federally Qualified Health Center (FQHC)	$0	$1.9M
Robert Mcdonald	MO	Otolaryngic Allergy Physician	$55.6K	$53K

Nearby Providers

Other providers in the same ZIP code as Northeastern Oklahoma Community Health Centers Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Creoks Mental Health Services	OK	Community/Behavioral Health Agency	$0	$12.5M
Northeastern Health System	OK	General Acute Care Hospital	$0	$9.8M
Cherokee Nation Home Health Outreach	OK	Case Management Agency	$0	$7.4M
Cherokee Nation	OK	General Acute Care Hospital	$0	$6.4M
Cornerstone Health Care Resources, LLC	OK	Case Management Agency	$0	$5.4M
Grace Medical Equipment, LLC.	OK	Oxygen Equipment & Supplies (DME)	$0	$2.8M
Cherokee Nation	OK	Land Ambulance	$451.8K	$2.1M
Northeastern Health System	OK	Land Ambulance	$0	$2.3M
Evolve Professional Counseling LLC	OK	Community/Behavioral Health Agency	$0	$2.1M
Northeastern Health System	OK	Emergency Medicine Physician	$0	$2.1M

Northeastern Oklahoma Community Health Centers Inc — Billing Profile & Reimbursement Data

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Northeastern Oklahoma Community Health Centers 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