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.

Grand Lake Mental Health Center, Inc. (NPI 1871500900)

Field	Value
Entity Type	Organization
Organization	Grand Lake Mental Health Center, Inc.
Address	109 N Fairland St
City	Pryor
State	OK
ZIP	74361
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	August 2, 2006

Payer Source	Total Paid
Medicaid	$24.8M
Medicare	$0

Key Findings

This provider is effectively single‑payer in practice: there is no Medicare billing on file and total Medicaid revenue is $24.8M, indicating near‑exclusive dependence on Medicaid for billed services. The NPI was enumerated 2006-08-02 (~20 years ago), so the organization has an established billing history confined to Medicaid rather than split across Medicare and Medicaid.

Revenue is highly concentrated in a single monthly bundled service: T1041 accounts for $24M and 96.8% of the provider's Medicaid revenue, and the precomputed top three Medicaid codes together account for 99.5% of total Medicaid revenue. Such concentration means most cashflow is derived from a small set of Medicaid payment categories rather than a broad fee‑for‑service mix.

The code mix and top revenue drivers identify the operation as a certified community behavioral health clinic model: T1041 (Medicaid certified community behavioral health clinic services, per month) dominates revenue, while coordinated care fees G9009 (1.5K claims, $503.7K revenue) and G9010 (148 claims, $149.5K revenue) make up the remainder of the top three. This pattern indicates the provider bills predominantly under monthly bundled CCBHC payments and risk‑adjusted coordinated care maintenance fees rather than per‑15‑minute psychotherapy or office visit codes.

State competitive standing for the major codes is solid but not monopolistic: T1041 ranks #10 of 97 providers in-state (91th percentile), signaling a strong statewide presence for that CCBHC monthly service; G9009 also ranks #10 of 73 (88th percentile), indicating similarly high relative volume for that coordinated care fee. By contrast G9010 sits at #21 of 44 (53th percentile), which places it closer to a typical mid‑range participant for that code in Oklahoma.

A large set of common behavioral health encounter codes appear with claim counts but show $0 avg paid/claim (for example H0004: 12.6K claims, $0 avg paid/claim; H2019: 1.3K claims, $0 avg paid/claim; H2015: 1.3K claims, $0 avg paid/claim). The presence of substantial claim volumes with $0 reported payment suggests these per‑unit service codes are being recorded but reimbursement is captured primarily through bundled monthly or maintenance fees (T1041/G9009/G9010) rather than discrete per‑service payments.

Traditional outpatient E/M office visit codes are de minimis in revenue and volume for this provider: 99213 (42 claims, $21 avg paid/claim, $882 revenue) and 99214 (213 claims, $4 avg paid/claim, $852 revenue) together contribute essentially no Medicaid revenue. This supports the interpretation that the clinic does not rely on standard office‑visit billing as a revenue driver and instead operates under behavioral health clinic payment structures.

Operational scale is reflected in high monthly‑service volume: 22.9K claims for T1041 indicate a sizable ongoing caseload under the CCBHC monthly billing model, and the 12.6K H0004 claims reflect substantial recorded therapy encounters even when those encounters are not producing separate paid line items. These volumes point to an organization delivering frequent, recurring behavioral health services to a broad Medicaid population rather than episodic, low‑volume specialty care.

Because top revenues are concentrated in T1041 (96.8% of Medicaid revenue) and the top three codes together account for 99.5% of Medicaid revenue, the provider's financial profile is highly sensitive to Medicaid policy or rate changes affecting CCBHC monthly payments and coordinated care fees. Any regulatory or reimbursement changes to those specific codes would likely have an outsized impact on this provider's revenue compared with changes to per‑visit or per‑15‑minute fee schedules.

Medicaid: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1041	Medicaid certified community behavioral health clinic services, per month	22,910	$1,050	$24M
G9009	Coordinated care fee, risk adjusted maintenance, level 3	1,460	$350	$503.7K
G9010	Coordinated care fee, risk adjusted maintenance, level 4	150	$1,010	$149.5K
G9002	Coordinated care fee, maintenance rate	910	$150	$133.2K
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…	40	$20	$880
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…	210	$1	$850
G0442	Annual alcohol misuse screening, 5 to 15 minutes	20	$0	$0
G8431	Screening for depression is documented as being positive and a follow-up plan is documented	130	$0	$0
H0002	Behavioral health screening to determine eligibility for admission to treatment program	380	$0	$0
H0004	Behavioral health counseling and therapy, per 15 minutes	12,590	$0	$0

Showing 1–10 of 20

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

Grand Lake Mental Health Center, Inc. — 0 of 6 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

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1041	Medicaid certified community behavioral health clinic services, per month	10	100	4,790	$880	$8.3M
T1016	Case management, each 15 minutes	113	140	3,200	$60	$2.3M
H0004	Behavioral health counseling and therapy, per 15 minutes	216	620	6,640	$70	$1.2M
G9009	Coordinated care fee, risk adjusted maintenance, level 3	10	70	320	$320	$317.4K
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…	1,204	1,680	820	$90	$307K
G9010	Coordinated care fee, risk adjusted maintenance, level 4	21	40	140	$970	$285.1K
H2017	Psychosocial rehabilitation services, per 15 minutes	186	240	1,280	$50	$259.4K
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…	1,521	1,750	870	$70	$254.4K
G9002	Coordinated care fee, maintenance rate	27	70	630	$140	$216.3K
T1017	Targeted case management, each 15 minutes	270	280	930	$30	$88.4K

Showing 1–10 of 20

Related Providers

Other providers that share a Tax Identification Number (TIN) with Grand Lake Mental Health Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grand Lake Mental Health Center, Inc.	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$47.2M
Grand Lake Mental Health Center, Inc.	OK	Community/Behavioral Health Agency	$0	$38.5M
Grand Lake Mental Health Center, Inc.	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$38.3M
Grand Lake Mental Health Center, Inc.	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$23M
Grand Lake Mental Health Center, Inc.	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$22.5M
Grand Lake Mental Health Center, Inc.	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$15.9M
Grand Lake Mental Health Center Inc	OK	Community/Behavioral Health Agency	$0	$15.4M
Grand Lake Mental Health Center Inc	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$11.7M
Grand Lake Mental Health Center, Inc.	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$11M
Grand Lake Mental Health Center, Inc.	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$9.8M

Nearby Providers

Other providers in the same ZIP code as Grand Lake Mental Health Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ahs Pryor Hospital, LLC	OK	General Acute Care Hospital	$0	$5.6M
Ahs Pryor Hospital, LLC	OK	Rural Health Clinic/Center	$0	$3.8M
Beggs Pharmacy Inc	OK	Durable Medical Equipment & Medical Supplies	$0	$3.4M
Grand Lake Mental Health Center Inc.	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$3.4M
Mayes Emergency Services Trust Authority	OK	Land Ambulance	$571.3K	$2.6M
Spring Dental Pryor	OK	General Practice Dentistry	$0	$1.7M
Khalid Aly	OK	Internal Medicine Physician	$718.2K	$0
Brett Howell	OK	Optometrist	$128.4K	$0
Saran Oliver	OK	Cardiovascular Disease Physician	$80.9K	$0
Wal-mart Stores East LP	OK	Community/Retail Pharmacy	$37.2K	$0

Grand Lake Mental Health Center, Inc. — Billing Profile & Reimbursement Data

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Grand Lake Mental Health Center, 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