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 1710953799)

Field	Value
Entity Type	Organization
Organization	Choctaw Nation Of Oklahoma
Address	109 Kerr Ave
City	Poteau
State	OK
ZIP	74953
Taxonomy	Primary Care Clinic/Center
NPI Enumerated	February 28, 2006

Payer Source	Total Paid
Medicaid	$30.3M
Medicare	$0

Key Findings

CHOCTAW NATION OF OKLAHOMA is a Primary Care Clinic/Center in POTEAU, OK with an NPI enumerated on 2006-02-28 (~20 years ago), indicating long tenure in the Medicare/Medicaid enrollment system. The registration date and taxonomy support interpretation of the billing mix as originating from an established primary care practice rather than a recently created entity or a specialty clinic.

This provider has no Medicare billing on file and reported $30.3M in lifetime Medicaid revenue, making it effectively a single-payer (Medicaid) operation in the available claims data. Analysts should treat comparisons to Medicare peers as inapplicable for this entity because there is no Medicare activity to benchmark.

Revenue is extremely concentrated in a very small set of procedure codes: the precomputed top 3 Medicaid codes account for 100.0% of the provider's total Medicaid revenue, and one code in particular dominates the ledger. 99212 alone is listed with $30.3M revenue (100.0% of this provider's total Medicaid revenue), showing near-total dependence on that single E/M code for Medicaid receipts.

The code mix and descriptions point to high-volume, lower-complexity office visits as the core service line. 99212 (established patient, straightforward decision making, 10+ minutes) accounts for 55.7K claims with an average paid/claim of $544, indicating the practice’s operations are focused on brief outpatient primary care encounters where extremely high visit volume drives total revenue.

On statewide competitive standing for the top code, the provider is an outlier: 99212 ranks #6 of 529 providers in-state (99th percentile; extreme outlier), which characterizes CHOCTAW NATION OF OKLAHOMA as a dominant in-state provider for that specific code. By contrast, the other listed codes are routine or minimal contributors: 99214 (56 claims, $27 avg paid/claim, $1.5K revenue) ranks #1442 of 1680 (14th percentile; typical, unremarkable), and 99213 (13 claims, $9 avg paid/claim, $117 revenue) ranks #1683 of 1746 (2th percentile; typical, unremarkable).

The concentration on 99212 creates strategic and revenue risk: any policy, reimbursement, or utilization change affecting that single E/M level could materially reduce the provider’s Medicaid receipts given that one code represents essentially all reported Medicaid revenue. This dependence also suggests operational focus on walk-in or quick follow-up visits rather than higher-complexity longitudinal care.

For analysts, the data signal priorities for further review: focus on Medicaid-facing operational metrics, coding and visit-level documentation for 99212 encounters, and in-state peer comparisons around that code. Because there is no Medicare activity to evaluate, benchmarking should center on Medicaid performance and the implications of being an extreme outlier on a single high-volume code.

Medicaid: Complete Services Breakdown

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

3 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,…	55,690	$540	$30.3M
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…	60	$30	$1.5K
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…	10	$10	$120

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 3 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

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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,…	6	530	140	$450	$1.2M
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…	1,442	1,680	820	$90	$307K
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…	1,683	1,750	870	$70	$254.4K

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	Rural Acute Care Hospital	$0	$83.5M
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	$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
Emergency Medical Services Of Leflore County	OK	Public Health or Welfare Agency	$1.3M	$4.8M
Brighter Heights Oklahoma, LLC	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$5.6M
Leflore County Hospital Authority	OK	Critical Access Hospital	$0	$5M
New Hope Counseling And Guidance Center LLC	OK	Counselor	$0	$4M
Leflore County Hospital Authority	OK	Rural Health Clinic/Center	$0	$3.7M
Kerry Mcclure, LLC	OK	Pediatric Occupational Therapist	$0	$2.8M
Eastern Oklahoma Mental Health & Counseling LLC	OK	Community/Behavioral Health Agency	$0	$2.2M
Serenity Counseling, Inc.	OK	Community/Behavioral Health Agency	$0	$1.8M
William Willis	OK	General Practice Physician	$310K	$0
Vanessa Lee	OK	Family Nurse Practitioner	$283.9K	$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