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.

Texomacare (NPI 1407800857)

Texomacare is a family medicine physician provider located in Madill, Oklahoma. This profile covers 0 Medicare and 34 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	Texomacare
Address	500 Brookside Dr
City	Madill
State	OK
ZIP	73446
Taxonomy	Family Medicine Physician
NPI Enumerated	May 20, 2006

Payer Source	Total Paid
Medicaid	$2.3M
Medicare	$0

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

34 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	15,450	$70	$1M
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…	10,930	$90	$939.6K
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…	960	$100	$92K
99442	N/A	520	$80	$41.3K
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.	970	$40	$36.7K
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,…	810	$50	$36.5K
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.	2,030	$10	$28.4K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	440	$60	$27.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	240	$100	$24.4K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	800	$30	$23.1K

Showing 1–10 of 34

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

Texomacare — 1 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

34 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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,…	313	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…	95	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…	88	1,750	870	$70	$254.4K
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…	209	280	470	$100	$140.8K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	174	190	80	$200	$128K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	235	300	100	$150	$79.5K
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…	105	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.	75	210	350	$40	$73.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	190	290	200	$90	$72.1K
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,…	82	290	260	$40	$69.7K

Showing 1–10 of 34

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mukesh Sheth	TX	Interventional Cardiology Physician	$344.6K	$0
Apurva Badheka	TX	Interventional Cardiology Physician	$344K	$0
Tung Tran	TX	Gastroenterology Physician	$322.6K	$0
Sudhir Thotakura	TX	Interventional Cardiology Physician	$280.1K	$0
Robert Sanders	TX	Internal Medicine Physician	$235.7K	$0
Kenneth Choi	TX	Pain Medicine (Anesthesiology) Physician	$232.8K	$0
Shannon Goodwin Chambers	OK	Family Medicine Physician	$215.4K	$0
Monica Mclaren	OK	Family Medicine Physician	$181.1K	$0
Onpan Cheung	TX	Gastroenterology Physician	$112.1K	$0
Karthik Ragunathan	TX	Gastroenterology Physician	$104.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Marshall County Hma LLC	OK	Rural Health Clinic/Center	$0	$4.3M
Marshall County Hma, LLC	OK	Critical Access Hospital	$0	$3M
Southeastern Oklahoma Family Services, Inc.	OK	Community/Behavioral Health Agency	$0	$1.9M
Looking Up Counseling	OK	Mental Health Counselor	$0	$1.9M
Marshall County Ems District	OK	Land Ambulance	$382.2K	$802.8K
Darin Goldsmith	OK	Physical Therapist	$109.9K	$0

Texomacare — Billing Profile & Reimbursement Data

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Texomacare — 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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