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.

Ou Medicine Inc. (NPI 1649794157)

Field	Value
Entity Type	Organization
Organization	Ou Medicine Inc.
Address	1200 Childrens Ave
City	Oklahoma City
State	OK
ZIP	73104
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 27, 2017

Payer Source	Total Paid
Medicaid	$63M
Medicare	$0

Key Findings

OU MEDICINE INC. reports $63M in lifetime Medicaid revenue and has no Medicare billing on file, making its observed footprint effectively single‑payer (Medicaid) in the dataset. The absence of Medicare billing means national Medicare comparisons are not applicable and all utilization and competitive analysis should be interpreted through the Medicaid lens.

Revenue is highly concentrated: the top three Medicaid codes by revenue — 99283, 99284, and 42820 — account for 64.2% of this provider's total Medicaid revenue. Those three codes alone drive the majority of the $63M Medicaid revenue, indicating dependence on a small set of services for most Medicaid dollars.

Service-line mix points to a high-volume emergency department alongside pediatric ENT procedural activity. ED evaluation-and-management codes appear repeatedly among top billers (99283: $17M; 99284: $14.1M; 99285: $2.8M; 99282: $2.6M), while surgical pediatric procedures for tonsil/adenoid removal (42820: $4.7M; 42830: $487.4K) show a meaningful operative practice that complements acute care. This pattern is consistent with a general acute care hospital operating a busy ED and an active pediatric ENT surgical service.

The provider is a statewide high-volume outlier on multiple operational and supply-use measures, which implies substantial throughput and downstream resource needs. Several codes are flagged as extreme outliers or at the top of state rankings: 99283 ranks #3 of 254 (99th percentile; extreme outlier), 96374 ranks #1 of 95 (100th percentile; extreme outlier), 36415 ranks #1 of 423 (100th percentile; extreme outlier), and 96375 and 96365 both rank #1 in their peer sets (100th percentiles). These rankings indicate this hospital captures far more Medicaid activity for those services than typical in-state peers.

Infusion, chemotherapy, and procedural administration are notable ancillary revenue sources supporting the ED and inpatient flows. High-revenue and high-volume administration codes include 96374 ($3.5M, #1 of 95, 100th percentile), 96375 ($568.1K, #1 of 90, 100th percentile), 96365 ($273K, #1 of 49, 100th percentile), and 96413 ($772.6K, #2 of 25, 96th percentile), showing a significant infusion/IV therapy capability in addition to diagnostic and ED services.

Laboratory and diagnostic throughput is substantial and includes pandemic-era testing volumes. High claim counts and state-leading ranks appear for basic venipuncture and lab panels (36415: 86K claims, $946.2K, #1 of 423, 100th percentile; 80053: 69.9K claims, $628.8K, #2 of 154, 99th percentile; 85027: 52.3K claims, $313.8K, #1 of 52, 100th percentile) and COVID testing codes (U0002: 13.1K claims, $653.1K, #1 of 49, 100th percentile; 87636: 5.2K claims, $660.6K, #1 of 32, 100th percentile), signaling a robust lab operation serving high Medicaid volumes.

Competitive posture within Oklahoma Medicaid is strong: multiple top-25 codes place OU MEDICINE INC. in the 96th–100th percentiles and often at rank #1 or top few positions in-state. These ranks (examples above) characterize the provider as a major Medicaid service hub in Oklahoma City for ED visits, infusion therapies, lab testing, and select pediatric surgeries rather than a modest or occasional participant for those lines of business.

The provider's NPI was enumerated on 2017-07-27 (~9 years ago), establishing nearly a decade of record activity in the data. Combined with the concentrated revenue mix and repeated state‑leading ranks, this tenure suggests an established Medicaid-focused acute care operation whose contractual relationships and network impact are likely material for payers managing Oklahoma City Medicaid populations.

Medicaid: Complete Services Breakdown

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

349 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	101,980	$170	$17M
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.	53,430	$260	$14.1M
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	1,260	$3,700	$4.7M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	25,530	$140	$3.5M
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.	8,130	$340	$2.8M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	25,830	$100	$2.6M
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	4,130	$370	$1.5M
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	3,120	$400	$1.2M
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	86,020	$10	$946.2K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	3,770	$210	$772.6K

Showing 1–10 of 349

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

Ou Medicine Inc. — 18 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

349 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	4	10	2,460	$230	$1.3M
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.	6	230	1,440	$170	$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.	3	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.	30	180	1,030	$200	$1M
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	183	200	1,720	$80	$645.7K
D9999	N/A	20	40	310	$690	$591.7K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	3	50	70	$1,800	$496.5K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	1	100	990	$130	$405.9K
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	18	20	60	$60	$404.2K
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…	1,423	1,680	820	$90	$307K

Showing 1–10 of 349

Related Providers

Other providers that share a Tax Identification Number (TIN) with Ou Medicine Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Glenna Young	OK	Diagnostic Radiology Physician	$147.1K	$0
Paula Deupree	OK	Body Imaging Physician	$122.9K	$0
Richard Falk	OK	Diagnostic Radiology Physician	$80.9K	$0
Andrew Conner	TX	Neurological Surgery Physician	$53.3K	$0

Nearby Providers

Other providers in the same ZIP code as Ou Medicine Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ou Health Partners, Inc	OK	Multi-Specialty Clinic/Center	$0	$118.5M
Board Of Regents Of The University Of Oklahoma - Ou Physicians	OK	Multi-Specialty Clinic/Center	$0	$96.6M
Oklahoma Allergy & Asthma Clinic	OK	Specialist	$0	$13.7M
University Of Oklahoma Heal Sci Ctr College Of Medicine Ophthalmology	OK	Ophthalmology Physician	$0	$9.5M
Emergency Physicians Of Midwest City, LLC	OK	Emergency Medicine Physician	$0	$8.1M
Board Of Regents Of The University Of Oklahoma-ou Physicians	OK	Clinic/Center	$0	$5.4M
Mcgee Eye Surgery Center LLC	OK	Ambulatory Surgical Clinic/Center	$2.8M	$2M
Questcare Em Oklahoma LLC	OK	Emergency Medicine Physician	$0	$4M
Dianon Systems Inc	OK	Clinical Medical Laboratory	$2.5M	$1.3M
Board Of Regents Of The University Of Oklahoma-ou Physicians	OK	Clinic/Center	$0	$3.1M

Ou Medicine 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