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 1659347623)

Field	Value
Entity Type	Organization
Organization	Choctaw Nation Of Oklahoma
Address	1 Choctaw Way
City	Talihina
State	OK
ZIP	74571
Taxonomy	Rural Acute Care Hospital
NPI Enumerated	February 28, 2006

Payer Source	Total Paid
Medicaid	$83.5M
Medicare	$0

Key Findings

CHOCTAW NATION OF OKLAHOMA is effectively a single-payer Medicaid provider: there is no Medicare billing on file while total Medicaid revenue is $83.5M, indicating operations are focused on Medicaid-covered services rather than Medicare populations. This payer mix implies clinical and financial dependence on state Medicaid reimbursement policies and managed care arrangements.

Revenue is extremely concentrated in a single Medicaid outpatient E/M code: 99212 accounts for $79.2M, which is 94.8% of the provider's total Medicaid revenue. The dominance of 99212 suggests the organization’s billing and cash flow are highly dependent on high-volume, lower-intensity outpatient encounters.

The code mix and top revenue drivers point to a primary service-line of ambulatory clinic visits and general outpatient care rather than high-acuity inpatient or specialty procedural work. The prevalence of 99212 (established patient office/outpatient E/M) plus T1015 (clinic visit/encounter, all-inclusive) together composing essentially all revenue supports a business model built around repeat primary care and clinic-based encounters.

CHOCTAW NATION ranks as a statewide outlier for its top Medicaid code: 99212 ranks #2 of 529 providers in Oklahoma and is labeled an extreme outlier, placing the provider in the 100th percentile for volume on that code. This indicates the provider is a dominant in-state source of routine outpatient E/M services under Medicaid, far above typical peers.

Other billed Medicaid codes are small contributors and reflect ancillary or situational services: T1015 contributes $4M (4.8% of Medicaid revenue) and ambulance-related codes A0425 and A0426 together contribute under $0.3M (0.3% combined). Those codes rank in modest percentiles statewide, suggesting occasional use of clinic-all-inclusive billing and transport services but not core revenue drivers.

Operational tenure is long-standing: the provider’s NPI was enumerated ~2006-02-28 (about 20 years ago), indicating an established presence in the market and time to develop referral patterns and workflows that generate sustained high outpatient visit volume.

Given the extreme concentration of revenue in 99212, the provider faces revenue risk if Medicaid policy or coding practice changes affect outpatient E/M valuations or utilization; conversely, its statewide dominance on that code could be leverage for contracting or care-delivery negotiations with state Medicaid plans.

Competitive implications by code: while 99212 shows dominant statewide market share and extreme outlier status, the provider’s lower ranks on inpatient and neonatal codes (e.g., 99238, 99460) indicate it is not a major Medicaid inpatient or newborn care provider in Oklahoma, reinforcing the ambulatory-focused profile.

Medicaid: Complete Services Breakdown

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

8 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,…	145,540	$540	$79.2M
T1015	Clinic visit/encounter, all-inclusive	9,790	$410	$4M
A0425	Ground mileage, per statute mile	280	$660	$187.2K
A0426	Ambulance service, advanced life support, non-emergency transport, level 1 (als 1)	280	$210	$57.6K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	140	$70	$9.4K
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…	170	$20	$3.7K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	50	$70	$3.5K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	20	$90	$2.1K

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 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

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	62	140	7,150	$220	$4.4M
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,…	2	530	140	$450	$1.2M
A0425	Ground mileage, per statute mile	91	110	2,080	$60	$501.9K
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…	1,242	1,680	820	$90	$307K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	239	280	840	$50	$179.5K
A0426	Ambulance service, advanced life support, non-emergency transport, level 1 (als 1)	15	40	90	$160	$132.4K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	76	160	130	$90	$84.6K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	71	90	100	$120	$73K

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	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	$25.3M
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
Adam Waldon	OK	Family Medicine Physician	$32.4K	$0

Choctaw Nation Of Oklahoma — Billing Profile & Reimbursement Data

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Choctaw Nation Of Oklahoma — 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