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.

Mercy Clinic Oklahoma Communities (NPI 1386874550)

Key Findings

Field	Value
Entity Type	Organization
Organization	Mercy Clinic Oklahoma Communities
Address	4300 W Memorial Rd
City	Oklahoma City
State	OK
ZIP	73120
Taxonomy	Family Medicine Physician
NPI Enumerated	July 21, 2009

Payer Source	Total Paid
Medicaid	$45.4M
Medicare	$0

This entity has no Medicare billing on file and reports $45.4M in lifetime Medicaid revenue, making it effectively a single‑payer (Medicaid‑focused) operation in the claims dataset. The absence of Medicare receipts means analysis of competitive standing and service mix should be centered on Medicaid activity.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 63.7% of total Medicaid revenue, driven by 99214 ($12.1M, 27.6%), 99213 ($10.3M, 23.3%), and 99285 ($5.6M, 12.8%). Those three codes together indicate most dollars flow from established‑patient ambulatory visits and high‑acuity emergency care rather than specialty procedures or durable medical equipment.

The taxonomy (Family Medicine Physician) plus the code mix suggests a broad primary care platform with significant emergency department throughput and routine preventive services: high volumes for 99214 and 99213 point to heavy ambulatory primary care; 99285 and 99284 show substantial ED care; preventive codes 99391/99392/99393 and vaccine codes 90460/90471 indicate a strong well‑patient and immunization program. This combination is consistent with a multi‑site community clinic or clinically integrated system that handles both routine primary care and urgent/emergent visits.

State competitive standing is dominant for several high‑revenue codes: 99213 ranks #1 of 1746 providers in‑state (100th percentile; extreme outlier) and 99214 ranks #2 of 1680 providers in‑state (100th percentile; extreme outlier), while 99285 ranks #5 of 182 providers in‑state (98th percentile; extreme outlier). These rank/percentile positions indicate the provider is an outsized Medicaid participant in both office E/M visits and high‑acuity ED services compared with peers across Oklahoma.

The provider also exhibits extreme outlier volumes in diagnostic and infectious disease testing: 87428 has 22.3K claims and $712.4K revenue (1.6%), ranking #1 of 134 providers in‑state (100th percentile; extreme outlier), and 87430 has 21.1K claims and $315.9K revenue (0.7%), ranking #1 of 64 providers in‑state (100th percentile; extreme outlier). High counts across 87428, 87430, 87804, and 87880 show substantial throughput for point‑of‑care and lab testing that aligns with heavy ambulatory and ED volumes.

Pediatric and preventive care are material revenue contributors: 99391 (17.3K claims, $1.5M, 3.4%) and 99392 (12.2K claims, $1.1M, 2.6%) both rank #4 in‑state (99th percentile; extreme outlier) and 99393 contributes $337.5K (0.8%). These figures indicate an outsized well‑child and preventive medicine footprint relative to peers, reinforcing the primary care orientation of the practice.

Services extend beyond outpatient visits into inpatient, observation, delivery, and critical care activity: notable entries include 59400 (405 claims, $727.8K, 1.7%), 99232 (18K claims, $720.2K, 1.6%), 99223 (2.3K claims, $244.8K, 0.6%), and 99291 (1.9K claims, $263.7K, 0.6%). Presence of global obstetric delivery revenue and hospital/critical care codes shows the provider’s Medicaid footprint covers continuity from ambulatory care through inpatient and emergent services.

The provider has a stable, long tenure in the NPI registry (enumerated 2009-07-21 (~17 years ago)), which, combined with the concentrated Medicaid revenue and top percentile ranks on multiple codes, suggests established payer relationships and an entrenched operational role in Oklahoma’s Medicaid network. This longevity supports interpreting the high volumes as consistent, sustained service delivery rather than a transient spike.

Medicaid: Complete Services Breakdown

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

161 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…	146,160	$80	$12.1M
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…	160,340	$60	$10.3M
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.	45,030	$130	$5.6M
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.	50,110	$100	$5M
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…	17,320	$90	$1.5M
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.	22,430	$60	$1.3M
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…	12,180	$90	$1.1M
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.	22,410	$50	$1M
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…	410	$1,800	$727.8K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	18,000	$40	$720.2K

Showing 1–10 of 161

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

Mercy Clinic Oklahoma Communities — 17 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

161 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.	7	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,…	20	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.	24	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.	5	180	1,030	$200	$1M
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	42	50	70	$1,800	$496.5K
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…	8	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…	2	1,680	820	$90	$307K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	55	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…	1	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…	34	190	480	$70	$218.8K

Showing 1–10 of 161

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
County Of Santa Clara	CA	Federally Qualified Health Center (FQHC)	$0	$175.9M
Scott Cooper	OK	Medical Physician Assistant	$4.4M	$0
Todd Mollet	OK	MOHS-Micrographic Surgery Physician	$2.1M	$0
Cherian Karunapuzha	OK	Neurology Physician	$809.4K	$0
Mohammad Ghani	OK	Interventional Cardiology Physician	$396.7K	$0
David Schomas	MO	Radiation Oncology Physician	$328.3K	$0
Marguerite Butchee	OK	Neurology Physician	$303.3K	$0
Faustino Kazenske	OK	Orthopaedic Surgery Physician	$293.5K	$0
Astrid Morrison	OK	Radiation Oncology Physician	$283.1K	$0
Tariq Mahmood	OK	Medical Oncology Physician	$253.8K	$17.8K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Hospital Oklahoma City, Inc	OK	General Acute Care Hospital	$0	$14.2M
Osu Center For Health Sciences	OK	Clinic/Center	$0	$11.6M
The Perinatal Center, PLLC	OK	Maternal & Fetal Medicine Physician	$0	$7.6M
Oklahoma Spine Surgery Center	OK	Ambulatory Surgical Clinic/Center	$6.8M	$708.6K
Childrens Eye Care P L L C	OK	Ophthalmology Physician	$0	$5.8M
Marquis Labs, LLC	OK	Clinical Medical Laboratory	$718.2K	$4.8M
Beacon Pointe, LLC	OK	Community/Behavioral Health Agency	$0	$3.5M
Ohh Physicians, LLC	OK	Cardiovascular Disease Physician	$0	$3.4M
Caring Home Health Agency Inc	OK	Home Health Agency	$0	$2.8M
Okc Dental Health Associates, P.C.	OK	General Practice Dentistry	$0	$2.8M

Mercy Clinic Oklahoma Communities — 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