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.

Oklahoma State Department Of Health (NPI 1477670529)

Key Findings

Field	Value
Entity Type	Organization
Organization	Oklahoma State Department Of Health
Address	4615 W Lakeview Rd
City	Stillwater
State	OK
ZIP	74075
Taxonomy	Clinical Medical Laboratory
NPI Enumerated	March 23, 2007

Payer Source	Total Paid
Medicaid	$19.9M
Medicare	$0

Payer mix is effectively single-payer: the provider reports no Medicare billing on file and $19.9M in lifetime Medicaid revenue, so Medicaid is the sole recorded payer source in this dataset and drives the entire observed billing footprint. This makes the entity highly exposed to state Medicaid policy and program-level demand rather than to Medicare population dynamics.

Revenue is concentrated in a small set of lab assays: the precomputed top three Medicaid codes account for 43.4% of this provider's total Medicaid revenue. The three top drivers are 83498 ($3.9M, 19.4%), 82139 ($2.4M, 12.0%), and 82261 ($2.4M, 12.0%), indicating a heavy reliance on a few high-volume tests for nearly half of Medicaid receipts.

Clinical and service-line profile aligns with public-health newborn/metabolic screening: the provider taxonomy is Clinical Medical Laboratory and the highest-revenue codes (83498, 82139, 82261, 82017, 84443) correspond to 17-hydroxyprogesterone, multi–amino acid panels, biotinidase, acylcarnitines, and TSH testing. This code mix is consistent with centralized, high-throughput newborn metabolic and endocrine screening rather than routine outpatient diagnostic testing.

Operational scale is very large and batch-oriented: many top codes show roughly 149K claims (e.g., 83498, 82139, 82261, 82017 listed at ~149K claims and 83020 at 149.8K claims) with relatively low avg paid/claim amounts, which is characteristic of population-level screening programs that process high specimen volumes at low per-test reimbursement. That pattern suggests a centralized lab processing standardized panels at scale.

Competitive standing in-state is dominant for multiple assays: the provider ranks #1 and sits at the 100th percentile for several high-volume codes (for example, 84443 is #1 of 79 providers and labeled an "extreme outlier, far above typical state volume for this code", while 83498 is #1 of 5 and 82139 is #1 of 3). These rank/percentile positions indicate the entity is a leading statewide provider for the specific screening and analytic services reflected in the top codes.

Statistical outlier characterization supports a specialized public-health role: 84443 is explicitly flagged as an "extreme outlier, far above typical state volume for this code," and multiple other high-volume codes are described as "notably above typical state volume" (83498, 83516, 81479, 83020). Conversely, several codes are described as "typical, unremarkable" within the state (for example, 82139 and 82017), indicating a mix of uniquely concentrated services and some routine testing volumes.

Tenure indicates an established operation: the NPI was enumerated on 2007-03-23 (~19 years ago), reflecting long-standing registration and likely sustained involvement in state lab services over nearly two decades. This longevity supports the interpretation of an institutional, programmatic laboratory rather than a recent entrant.

Strategic and financial implications: because nearly half of Medicaid revenue is tied to three assays and the entire billing base is Medicaid ($19.9M), changes to state newborn screening policies, Medicaid reimbursement rates, or consolidation of state screening contracts could materially affect this provider's revenue. The data suggest reliance on large-volume, low-margin screening work, reinforcing sensitivity to payer policy and program-level demand.

Medicaid: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
83498	The lab analyst measures the 17 hydroxyprogesterone in a sample such as blood, serum, urine, or even amniotic fluid. This hormone is a building block for the adrenal cortex hormone cortisol.	148,960	$30	$3.9M
82139	The lab analyst performs testing for 6 or more amino acids, usually on a specimen such as blood, plasma, urine, or other body fluids, by quantitative analysis to determine if any are outside the…	149,020	$20	$2.4M
82261	The lab analyst performs a measurement of the enzyme biotinidase, typically on a blood sample. This enzyme test is useful for the identification of a deficiency of biotinidase and also for the…	148,960	$20	$2.4M
82017	This test is for the analysis of quantitative acylcarnitines, which clinicians use to diagnose various fatty acid metabolic disorders. The clinician may also use this testing to help determine the…	148,950	$20	$2.4M
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	148,940	$20	$2.4M
82760	The lab analyst measures the level of galactose, a simple sugar, on serum, plasma, or urine. This sugar is normally broken down to glucose in the body and metabolized or excreted. Without the proper…	148,950	$10	$1.6M
83516	The lab analyst performs the technical immunoassay test involving several steps to detect and measure an analyte of a noninfectious nature. The results show as positive or negative, or in…	148,890	$10	$1.6M
81479	Use 81479 to report a molecular pathology procedure that does not have a specific code.	148,870	$10	$1.2M
82657	The lab analyst measures the enzyme activity found from within the cells, which can be from a variety of locations including tissue. He uses a nonradioactive substrate for the test. Use this code…	64,090	$20	$1.2M
83020	The lab analyst records and calculates the hemoglobin fractions in a whole blood sample demonstrated by this hemoglobin fractionation test by electrophoresis.	149,750	$10	$898.5K

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

Oklahoma State Department Of Health — 8 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

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
82261	The lab analyst performs a measurement of the enzyme biotinidase, typically on a blood sample. This enzyme test is useful for the identification of a deficiency of biotinidase and also for the…	1	10	148,960	$20	$2.4M
82760	The lab analyst measures the level of galactose, a simple sugar, on serum, plasma, or urine. This sugar is normally broken down to glucose in the body and metabolized or excreted. Without the proper…	1	10	148,950	$10	$1.6M
82017	This test is for the analysis of quantitative acylcarnitines, which clinicians use to diagnose various fatty acid metabolic disorders. The clinician may also use this testing to help determine the…	1	10	74,550	$20	$1.2M
82139	The lab analyst performs testing for 6 or more amino acids, usually on a specimen such as blood, plasma, urine, or other body fluids, by quantitative analysis to determine if any are outside the…	1	10	260	$20	$798.3K
83498	The lab analyst measures the 17 hydroxyprogesterone in a sample such as blood, serum, urine, or even amniotic fluid. This hormone is a building block for the adrenal cortex hormone cortisol.	1	10	300	$30	$782.5K
82657	The lab analyst measures the enzyme activity found from within the cells, which can be from a variety of locations including tissue. He uses a nonradioactive substrate for the test. Use this code…	1	10	270	$20	$296.2K
81479	Use 81479 to report a molecular pathology procedure that does not have a specific code.	1	10	40	$10	$267.7K
83516	The lab analyst performs the technical immunoassay test involving several steps to detect and measure an analyte of a noninfectious nature. The results show as positive or negative, or in…	1	10	290	$10	$223.6K
83020	The lab analyst records and calculates the hemoglobin fractions in a whole blood sample demonstrated by this hemoglobin fractionation test by electrophoresis.	1	10	230	$10	$130.2K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	1	80	280	$20	$72.5K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grand Lake Mental Health Center Inc	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$11.7M
Oklahoma Cvs Pharmacy LLC	OK	Pharmacy	$102.8K	$0
Tamara Wales	OK	Occupational Therapist	$34.5K	$0
Abby O'dell	OK	Speech-Language Pathologist	$14K	$0
Najma Hamdani	OK	Psychiatry Physician	$5.8K	$0

Oklahoma State Department Of Health — Billing Profile & Reimbursement Data

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Oklahoma State Department Of Health — 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

Nearby Providers

Frequently Asked Questions

References