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 Wisconsin for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Wisconsin 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. Wisconsin (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.

Oak Medical Sc (NPI 1669910345)

Oak Medical Sc is a internal medicine physician provider located in Waukesha, Wisconsin. This profile covers 0 Medicare and 33 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Oak Medical Sc
Address	N20w22961 Watertown Rd
City	Waukesha
State	WI
ZIP	53186
Taxonomy	Internal Medicine Physician
NPI Enumerated	February 2, 2017

Payer Source	Total Paid
Medicaid	$4M
Medicare	$0

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

33 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	85,570	$20	$2M
99310	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends…	36,890	$30	$1.1M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	14,000	$20	$308K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	16,420	$20	$246.2K
99306	The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves high medical decision making, and/or the provider spends at least…	4,710	$30	$145.9K
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…	5,750	$20	$92.1K
99349	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	1,020	$40	$38.7K
99348	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves low medical decision making or the provider spends at least 30…	680	$20	$15.6K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	340	$40	$14.1K
99336	N/A	800	$10	$10.4K

Showing 1–10 of 33

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.

Claims Volume vs. Wisconsin Distribution

Oak Medical Sc — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

33 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	7	170	240	$20	$68.9K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	137	170	110	$80	$62.4K
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…	41	240	420	$10	$58.8K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	86	120	120	$60	$56.6K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	51	140	340	$30	$49.2K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	66	120	90	$50	$45K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	1	140	300	$20	$43.8K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	50	140	170	$50	$39.4K
99310	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends…	1	50	150	$30	$39.3K
99337	N/A	9	10	160	$20	$34.8K

Showing 1–10 of 33

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ana Perelman	WI	Internal Medicine Physician	$368.6K	$0
Ryan Holzmacher	WI	Internal Medicine Physician	$293.1K	$0
Sarfraz Sidhu	WI	Internal Medicine Physician	$232.6K	$0
Sara Stein	WI	Nurse Practitioner	$180.9K	$0
Michael Sullivan	WI	Family Medicine Physician	$166.7K	$0
Dina Sotola	WI	Family Nurse Practitioner	$164.6K	$0
Ralph Laraiso	WA	Physical Medicine & Rehabilitation Physician	$155.4K	$0
Jasdeep Sidhu	WI	Cardiovascular Disease Physician	$144.7K	$0
Courtney Lamm	WI	Primary Care Nurse Practitioner	$144K	$0
Muniba Chohan	WI	Internal Medicine Physician	$137.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grace Machi	WI	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$5.5M
Kci Usa, Inc.	WI	Durable Medical Equipment & Medical Supplies	$0	$4.8M
Waukesha School District	WI	Local Education Agency (LEA)	$0	$3.3M
Lss Aspen Center LLC	WI	Substance Abuse Rehabilitation Facility	$0	$2.9M
Planned Parenthood Of Wisconsin	WI	Ambulatory Family Planning Facility	$0	$2.5M
Douglas Hempel	WI	Rheumatology Physician	$1.9M	$0
Lincare Inc.	WI	Durable Medical Equipment & Medical Supplies	$0	$1.6M
Matt Talbot Recovery Services, Inc	WI	Substance Abuse Rehabilitation Facility	$0	$1.3M
Mark Pearson	WI	Rheumatology Physician	$972.6K	$0
Carly Skamra	WI	Rheumatology Physician	$943.5K	$0

Oak Medical Sc — Billing Profile & Reimbursement Data

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Oak Medical Sc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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