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 1952377939)

Field	Value
Entity Type	Organization
Organization	Choctaw Nation Of Oklahoma
Address	1127 S George Nigh Expy
City	Mcalester
State	OK
ZIP	74501
Taxonomy	Primary Care Clinic/Center
NPI Enumerated	February 28, 2006

Payer Source	Total Paid
Medicaid	$38M
Medicare	$0

Key Findings

CHOCTAW NATION OF OKLAHOMA is effectively a single-payer outpatient operation in the available data: no Medicare billing is on file while total Medicaid revenue is reported as $38M, indicating the provider’s public-payer footprint is concentrated in Medicaid rather than split between Medicare and Medicaid. This makes Medicaid reimbursement trends the primary driver of the organization’s revenue profile.

Revenue concentration is extreme: the precomputed top-3 Medicaid codes account for 100.0% of this provider’s total Medicaid revenue, and a single code, 99212, is reported with $38M in revenue (100.0% of the provider’s Medicaid revenue). This indicates virtually all Medicaid dollars for this NPI are tied to a single CPT/HCPCS service line.

The code mix signals a primary-care, office-visit–centric operation: 99212 (established patient, straightforward E/M, 10+ minutes) dominates the revenue picture with 68.6K claims and an average paid/claim of $554, producing $38M in revenue. By contrast, 99214 (moderate-complexity E/M, 30+ minutes) appears only 12 times for $180 total, implying visits coded at higher complexity are negligible in the billing mix.

99212 shows a strong competitive position in-state: it ranks #5 of 529 providers and is in the 99th percentile, labeled an "extreme outlier, far above typical state volume for this code." That ranking and volume indicate the provider is a major in-state source of this specific outpatient visit service and is operating at far higher-than-typical scale for 99212.

In contrast, 99214 is essentially absent as a revenue driver — 12 claims, $15 avg paid/claim, $180 revenue (0.0% of Medicaid revenue), and a rank of #1654 of 1680 (0th percentile), described as typical and unremarkable. This contrast between very high-volume low-complexity visits and near-zero higher-complexity visits suggests clinical throughput emphasizes frequent, brief established-patient encounters rather than longer, more complex evaluations.

The payment characteristics are notable: 99212 shows an average paid/claim of $554 across 68.6K claims generating $38M. That combination of high per-claim payment and very large claim volume is the proximate cause of the provider’s Medicaid revenue concentration and should be a focus for any payer analytic, rate-setting, or utilization review work.

Operationally the entity has long tenure: the NPI was enumerated 2006-02-28 (~20 years ago), indicating an established presence in the market. Coupled with the concentrated Medicaid revenue base, the provider’s financial stability and contracting leverage will be tightly linked to Medicaid policy and regional demand for high-volume 99212 office visits.

Medicaid: Complete Services Breakdown

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

2 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,…	68,580	$550	$38M
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…	10	$20	$180

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 2 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

2 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,…	5	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…	1,654	1,680	820	$90	$307K

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	$30.3M
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
State Of Oklahoma	OK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$13.2M
Caring Hands Healthcare Centers, Inc	OK	Federally Qualified Health Center (FQHC)	$0	$10.9M
Mcalester Regional Health Center Authority	OK	Rural Acute Care Hospital	$0	$10.1M
Southern Oklahoma Treatment Services, Inc.	OK	Community/Behavioral Health Agency	$0	$5M
Completecare Private Services, LLC	OK	Home Health Agency	$0	$4.5M
Ergonomic Consultants, LLC	OK	Multi-Specialty Clinic/Center	$0	$3.7M
Mcalester Children's Dental Clinic	OK	Dental Clinic/Center	$0	$3.3M
Mcalester Medical Services, LLC	OK	Internal Medicine Physician	$0	$2.9M
Kennedy Eyecare LLC	OK	Optometrist	$0	$2.6M
Kathleen Ward	OK	Clinical Psychologist	$0	$2.6M

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