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.

Stanbro Healthcare Group LLC (NPI 1942592886)

Stanbro Healthcare Group LLC is a child & adolescent psychiatry physician provider located in Edmond, Oklahoma. This profile covers 0 Medicare and 9 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	Stanbro Healthcare Group LLC
Address	2000 E 15th St
City	Edmond
State	OK
ZIP	73013
Taxonomy	Child & Adolescent Psychiatry Physician
NPI Enumerated	May 11, 2011

Payer Source	Total Paid
Medicaid	$2.9M
Medicare	$0

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	17,890	$100	$1.8M
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…	8,430	$70	$606.7K
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…	4,850	$60	$296K
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…	400	$140	$57.1K
90785	This add–on code represents increased work intensity of psychotherapy services that adds difficulty to delivery of service.	2,440	$10	$34.1K
90836	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…	440	$70	$31.8K
90838	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…	110	$100	$11.3K
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…	50	$180	$8.6K
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…	30	$160	$4.6K

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

Stanbro Healthcare Group LLC — 2 of 9 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

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	49	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…	193	1,750	870	$70	$254.4K
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…	203	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…	221	300	100	$150	$79.5K
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…	4	80	330	$60	$60.5K
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…	82	150	60	$210	$50.3K
90838	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…	7	10	170	$100	$48K
90836	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…	2	20	70	$70	$11.7K
90785	This add–on code represents increased work intensity of psychotherapy services that adds difficulty to delivery of service.	19	100	350	$1	$8.1K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Specialty Care Pediatrics, Inc.	OK	Home Health Agency	$0	$44.8M
Medical Resource Management, LLC	OK	Urgent Care Clinic/Center	$0	$14.9M
Oklahoma Arthritis Center, P.C.	OK	Rheumatology Physician	$0	$10.1M
Craig Carson	OK	Rheumatology Physician	$9.7M	$0
Sand Lily Healthcare, Inc.	OK	In Home Supportive Care Agency	$0	$8.9M
Christopher Fisher	OK	Internal Medicine Physician	$7.6M	$0
Summit Medical Center	OK	General Acute Care Hospital	$0	$7.1M
Brian Phelps	OK	Retina Specialist (Ophthalmology) Physician	$4.1M	$0
Ana Kumar	OK	Rheumatology Physician	$4.1M	$0
Sandeep Shah	OK	Retina Specialist (Ophthalmology) Physician	$3.9M	$0

Stanbro Healthcare Group LLC — 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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References