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.

Grand Lake Mental Health Center, Inc. (NPI 1497762520)

Field	Value
Entity Type	Organization
Organization	Grand Lake Mental Health Center, Inc.
Address	111 S Treaty Rd
City	Miami
State	OK
ZIP	74354
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	August 2, 2006

Payer Source	Total Paid
Medicaid	$23M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-centric operation: there is no Medicare billing on file and total Medicaid revenue is listed as $23M. The absence of Medicare activity combined with materially sized Medicaid receipts indicates the organization’s payer exposure and revenue risk are concentrated in state Medicaid programs rather than federal Medicare business.

Revenue is extremely concentrated in a single monthly community clinic payment stream: the top 3 Medicaid codes account for 99.4% of the provider’s Medicaid revenue. T1041 alone generates $22.4M (97.2% of Medicaid revenue), with G9009 at $352.6K (1.5%) and G9002 at $154.2K (0.7%), so most of the provider’s dollars flow through these three codes.

The code mix and dollar concentration point to an operation built around certified community behavioral health clinic monthly payments (T1041), implying ongoing, per-member/per-month community behavioral health services are the primary service line. Many other behavioral and case-management codes appear frequently in claims (for example H0004: 10.2K claims; H2015: 1.9K claims; T1016: 1K claims) but show $0 average paid per claim, which is consistent with a reimbursement model where a monthly clinic rate captures payment for a bundle of services.

Grand Lake Mental Health Center has a meaningful statewide presence for the core community clinic payment: it ranks #11 of 97 providers in-state for T1041 (90th percentile). That ranking indicates a strong regional footprint for the principal revenue driver, though it is not the single dominant provider statewide.

Participation in coordinated care fee lines is present but not dominant: G9009 ranks #16 of 73 providers in-state (79th percentile) and G9002 ranks #24 of 70 (67th percentile), while risk‑adjusted level codes such as G9010 rank lower (#27 of 44, 40th percentile). These positions indicate steady, above‑median engagement with coordinated care fee structures without top-tier market leadership in those subcomponents.

Several ancillary and therapy codes show high claim volumes but $0 paid amounts, signaling that clinical activity is being recorded for services that may be included in bundled monthly payments or reimbursed outside of fee-for-service lines. Notably, S5110 (129 claims) ranks #1 of 14 providers in-state (100th percentile; notably above typical state volume for this code) despite generating no standalone Medicaid revenue, which suggests distinctive programmatic activity in family/home-care training relative to peers.

The provider has long tenure in the billing system, with its NPI enumerated on 2006-08-02 (~20 years ago). That duration supports the interpretation of an established community behavioral health provider with sustained participation in state Medicaid programs and likely operational relationships with Medicaid-managed care or state behavioral-health authorities.

Medicaid: Complete Services Breakdown

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1041	Medicaid certified community behavioral health clinic services, per month	21,200	$1,060	$22.4M
G9009	Coordinated care fee, risk adjusted maintenance, level 3	1,020	$350	$352.6K
G9002	Coordinated care fee, maintenance rate	1,060	$150	$154.2K
G9010	Coordinated care fee, risk adjusted maintenance, level 4	100	$1,010	$104K
G9005	Coordinated care fee, risk adjusted maintenance	50	$450	$22.2K
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…	1,410	$10	$9.9K
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…	230	$30	$6.1K
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…	10	$1	$10
G0442	Annual alcohol misuse screening, 5 to 15 minutes	10	$0	$0
G8431	Screening for depression is documented as being positive and a follow-up plan is documented	30	$0	$0

Showing 1–10 of 22

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

Grand Lake Mental Health Center, Inc. — 0 of 8 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

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1041	Medicaid certified community behavioral health clinic services, per month	11	100	4,790	$880	$8.3M
T1016	Case management, each 15 minutes	83	140	3,200	$60	$2.3M
H0004	Behavioral health counseling and therapy, per 15 minutes	248	620	6,640	$70	$1.2M
G9009	Coordinated care fee, risk adjusted maintenance, level 3	16	70	320	$320	$317.4K
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…	1,188	1,680	820	$90	$307K
G9010	Coordinated care fee, risk adjusted maintenance, level 4	27	40	140	$970	$285.1K
H2017	Psychosocial rehabilitation services, per 15 minutes	172	240	1,280	$50	$259.4K
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…	727	1,750	870	$70	$254.4K
G9002	Coordinated care fee, maintenance rate	24	70	630	$140	$216.3K
G9005	Coordinated care fee, risk adjusted maintenance	15	20	120	$450	$99.6K

Showing 1–10 of 22

Related Providers

Other providers that share a Tax Identification Number (TIN) with Grand Lake Mental Health Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grand Lake Mental Health Center, Inc.	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$47.2M
Grand Lake Mental Health Center, Inc.	OK	Community/Behavioral Health Agency	$0	$38.5M
Grand Lake Mental Health Center, Inc.	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$38.3M
Grand Lake Mental Health Center, Inc.	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$24.8M
Grand Lake Mental Health Center, Inc.	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$22.5M
Grand Lake Mental Health Center, Inc.	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$15.9M
Grand Lake Mental Health Center Inc	OK	Community/Behavioral Health Agency	$0	$15.4M
Grand Lake Mental Health Center Inc	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$11.7M
Grand Lake Mental Health Center, Inc.	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$11M
Grand Lake Mental Health Center, Inc.	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$9.8M

Nearby Providers

Other providers in the same ZIP code as Grand Lake Mental Health Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Integris Miami Hospital	OK	General Acute Care Hospital	$0	$7.3M
Modoc Nation Behavioral Health	OK	Adolescent and Children Mental Health Clinic/Center	$0	$6.5M
Doc Services, Inc	OK	Home Delivered Meals	$0	$4.5M
Integris Miami Hospital	OK	Rural Health Clinic/Center	$0	$4.3M
Community Health Center Of Southeast Kansas, Inc.	OK	Federally Qualified Health Center (FQHC)	$0	$3.7M
Smiles Family Dental Care, Plc	OK	General Practice Dentistry	$0	$1.9M
Muzaffar Hussain	OK	Orthopaedic Surgery Physician	$405.1K	$0
Matthew Roberts	OK	Foot & Ankle Surgery Podiatrist	$156K	$0
Bradford Stephens	OK	Specialist	$141.4K	$0
Martin Grotheer	OK	Family Medicine Physician	$105.9K	$0

Grand Lake Mental Health Center, Inc. — Billing Profile & Reimbursement Data

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Grand Lake Mental Health Center, 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