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.

Choctaw Nation Of Oklahoma (NPI 1407822497)

Field	Value
Entity Type	Organization
Organization	Choctaw Nation Of Oklahoma
Address	902 E Lincoln Rd
City	Idabel
State	OK
ZIP	74745
Taxonomy	Primary Care Clinic/Center
NPI Enumerated	February 28, 2006

Payer Source	Total Paid
Medicaid	$25.3M
Medicare	$0

Key Findings

CHOCTAW NATION OF OKLAHOMA operates effectively as a Medicaid-focused outpatient primary care site: there is no Medicare billing on file and reported Medicaid revenue totals $25.3M, indicating a payer mix that is functionally single-payer toward Medicaid. The provider is categorized as a Primary Care Clinic/Center, which aligns with the billing patterns observed.

Revenue is extremely concentrated in a single service line: the precomputed top-3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue, with 99212 alone reported as $25.3M of revenue. This concentration means the provider’s Medicaid financial performance is driven almost entirely by office/outpatient established-patient evaluation-and-management visits.

Code-level volume and unit payments show the dominant driver is 99212 (established patient office visit), with 48K claims and an average paid/claim of $528, generating $25.3M in revenue and representing the vast majority of billings. That combination of very high claim count and a relatively high average payment per claim underlines a high-throughput ambulatory clinic model focused on straightforward E/M encounters.

Competitive standing for the top code is strong in-state: 99212 ranks #8 of 529 providers in Oklahoma (99th percentile) and is explicitly described as "notably above typical state volume." This places the provider among the highest-volume state peers for basic established-patient outpatient visits, suggesting local market prominence in that specific service.

Other E/M codes appear only at de minimis levels by revenue and do not materially diversify the mix: 99214 shows 59 claims at $24 avg paid/claim for $1.4K in revenue (0.0% of total Medicaid revenue) and ranks #1430 of 1680 in-state (15th percentile), while 99215 shows 13 claims at $22 avg paid/claim for $286 in revenue (0.0% of total) and ranks #271 of 302 in-state (5th percentile). Both are characterized as typical, unremarkable volumes, indicating limited delivery of higher-complexity established-patient visits.

Operational implications follow from the code mix: dominance of 99212 implies workflows optimized for high-volume, straightforward visits (brief evaluation and management encounters of 10+ minutes), and the clinic likely emphasizes access and throughput rather than complex chronic-care visits. Because the top-3 codes account for 100.0% of Medicaid revenue, any changes in utilization patterns or reimbursement for these E/M codes could materially affect total revenue.

Tenure data show the provider has been enumerated since 2006-02-28 (~20 years ago), indicating an established presence in the market; this longevity, combined with high 99212 volume, suggests stable patient demand for routine outpatient care. The lack of Medicare billing on file implies either limited engagement with Medicare populations or billing structuring that excludes Medicare claims from this NPI.

From a competitive and risk perspective, the provider is a major in-state volume performer for low-complexity E/M care but is narrowly focused: the provider’s strength (99th percentile ranking on 99212) coexists with a high concentration of revenue in that single code family. Analysts should view the business as operationally strong for basic primary care access while also being vulnerable to shifts in E/M coding practices, state Medicaid policy, or per-claim payment changes given the concentration reflected in the data.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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,…	47,960	$530	$25.3M
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…	60	$20	$1.4K
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…	10	$20	$290

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

Choctaw Nation Of Oklahoma — 1 of 3 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

3 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,…	8	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…	1,430	1,680	820	$90	$307K
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…	271	300	100	$150	$79.5K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Choctaw Nation Of Oklahoma, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Choctaw Nation Of Oklahoma	OK	Rural Acute Care Hospital	$0	$83.5M
Choctaw Nation Of Oklahoma	OK	Primary Care Clinic/Center	$0	$40.3M
Choctaw Nation Of Oklahoma	OK	Primary Care Clinic/Center	$0	$38M
Choctaw Nation Of Oklahoma	OK	Primary Care Clinic/Center	$0	$30.3M
Choctaw Nation Of Oklahoma	OK	Primary Care Clinic/Center	$0	$9M
Choctaw Nation Of Oklahoma	OK	Primary Care Clinic/Center	$0	$7M
Choctaw Nation Of Oklahoma	OK	Primary Care Clinic/Center	$0	$4.8M
Choctaw Nation Of Oklahoma	OK	Primary Care Clinic/Center	$0	$3.2M
Matthew Phillips	OK	Ophthalmology Physician	$871.6K	$0
Ronald Kingsley	OK	Retina Specialist (Ophthalmology) Physician	$831.8K	$0

Nearby Providers

Other providers in the same ZIP code as Choctaw Nation Of Oklahoma, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mccurtain Memorial Medical Management, Inc.	OK	Critical Access Hospital	$0	$5.8M
Ultimate Home Care LLC, Dba Oak View Health Services	OK	Case Management Agency	$0	$4.7M
Brighter Heights Oklahoma, LLC	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$3.9M
Mccurtain County Emergency Medical Services	OK	Ambulance	$793.6K	$2.7M
Kiamichi Family Medical Center Inc.	OK	Federally Qualified Health Center (FQHC)	$0	$2.9M
Osu Center For Health Sciences	OK	Medical Specialty Clinic/Center	$0	$2.5M
Complete Care Medical, Inc.	OK	Durable Medical Equipment & Medical Supplies	$0	$2.5M
Air Evac Ems, Inc.	OK	Air Ambulance	$1.1M	$1.3M
Mccurtain Memorial Medical Management, Inc.	OK	Certified Registered Nurse Anesthetist	$0	$2.2M
Stathealth Clinic PLLC	OK	Primary Care Clinic/Center	$0	$1.9M

Choctaw Nation Of Oklahoma — Billing Profile & Reimbursement Data

Sign up for Choctaw Nation Of Oklahoma — Billing Profile & Reimbursement Data policy alerts

Choctaw Nation Of Oklahoma — Billing Profile & Reimbursement Data

Sign up for Choctaw Nation Of Oklahoma — Billing Profile & Reimbursement Data policy alerts

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