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.

Okc Kids Urology PLLC (NPI 1851868863)

Okc Kids Urology PLLC is a pediatrics physician provider located in Oklahoma City, Oklahoma. This profile covers 0 Medicare and 16 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	Okc Kids Urology PLLC
Address	3705 Nw 63rd St Ste 211
City	Oklahoma City
State	OK
ZIP	73116
Taxonomy	Pediatrics Physician
NPI Enumerated	October 28, 2018

Payer Source	Total Paid
Medicaid	$1.6M
Medicare	$0

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
54150	The provider performs a circumcision, a surgical procedure that removes the foreskin of the penis, using a clamp or other device and regional anesthesia consisting of a dorsal penile or ring block.	3,620	$100	$368.9K
99204	The provider sees a new 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 provider…	1,830	$140	$262.1K
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	2,490	$90	$213.8K
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…	2,230	$100	$213.6K
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…	1,620	$100	$161.9K
76770	A retroperitoneal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e.Kidneys, urinary bladder, and aorta). This particular code is used when the ultrasound is…	1,590	$90	$142.9K
54360	The provider surgically repairs the angulation, or abnormal curvature, of the penis of the patient.	200	$610	$120.6K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	300	$180	$54.6K
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,…	960	$50	$45.9K
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…	350	$80	$26.8K

Showing 1–10 of 16

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

Okc Kids Urology PLLC — 2 of 16 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

16 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,…	100	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…	600	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…	1,110	1,750	870	$70	$254.4K
54161	The provider excises the foreskin of a patient older than 28 days; the provider uses a technique other than a clamp, other devices, or dorsal slit.	5	10	180	$600	$114.2K
76770	A retroperitoneal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e.Kidneys, urinary bladder, and aorta). This particular code is used when the ultrasound is…	7	20	240	$50	$96.6K
99204	The provider sees a new 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 provider…	54	720	120	$150	$94.5K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	288	300	100	$150	$79.5K
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…	46	710	140	$100	$74.6K
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	5	40	170	$90	$71.2K
54360	The provider surgically repairs the angulation, or abnormal curvature, of the penis of the patient.	1	10	40	$700	$58.3K

Showing 1–10 of 16

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Pathways Unlimited Inc	OK	Clinical Psychologist	$0	$27.7M
Generations Community Services LLC	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$11.7M
Sensational Kids, Inc.	OK	Contractor	$0	$6.8M
Qitek Labs Of Oklahoma LLC	OK	Clinical Medical Laboratory	$6.2M	$10.1K
New Horizon Youth & Family Services, LLC	OK	Community/Behavioral Health Agency	$0	$4.5M
Guidance Counseling Of Oklahoma LLC	OK	Community/Behavioral Health Agency	$0	$4.1M
Latisha Heinlen	OK	Rheumatology Physician	$3.6M	$0
Dental Depot Of 63rd & Nw Expressway, PLLC	OK	Dental Clinic/Center	$0	$3.4M
Dental Depot Orthodontics Central Okc PLLC	OK	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$3.3M
3-j Enterprises, LLC	OK	Durable Medical Equipment & Medical Supplies	$0	$2.8M

Okc Kids Urology PLLC — Billing Profile & Reimbursement Data

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Okc Kids Urology PLLC — 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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