IDR Data
CMS PUF data · 2023 Q1–2025 Q4

Federal IDR outcomes: Emergency medicine and emergency departments in Oklahoma

In 2025 Q1–Q4, the provider or facility offer prevailed in 93.4% of 90,054 determined Federal IDR dispute line items for emergency medicine and emergency departments in Oklahoma. The median prevailing offer was 5.64x the QPA (25th–75th percentile 3.14x–13.79x; n = 87,201). The median time to a decision was 33 business days (n = 90,054).

Determined line items

90,054

2025 Q1–Q4 · 34 split decisions excluded

Provider win rate

93.4%

n = 90,054 · 2025 Q1–Q4

Median payment vs QPA

5.64x

middle half 3.14x–13.79x · n = 87,201 · 2025 Q1–Q4

Median days to decision

33

business days, from dispute initiation · n = 90,054 · 2025 Q1–Q4

Dollar amounts are not shown for specialty groups: the CMS QPA and Offers file, the only source of dollar figures, has no specialty field. See methodology.

By period

PeriodLine itemsWin %Median ×QPA25th–75thRatio nMedian days
2025 Q1–Q490,05493.4%5.64x3.14x–13.79x87,20133
2024 Q1–Q412,29188.0%2.93x2.57x–3.81x12,14694
2023 Q1–Q41,59378.7%2.75x2.39x–3.71x1,59174
2023 Q1–2025 Q4103,93892.6%4.92x3.01x–12.42x100,938not pooled

Line items = determined dispute line items (n). Win rate excludes split decisions and includes default decisions. Ratio n = line items reporting a payment-to-QPA ratio. Days are business days as reported by CMS (2023–2024: from IDR entity assignment; 2025: from initiation) and are never pooled.

Most disputed CPT codes

CPT codeLine itemsWin %Median ×QPARatio nMedian days
99284 Emergency department visit with moderate level of medical decision making27,11992.3%4.05x26,56233
99285 Emergency department visit with high level of medical decision making11,87592.1%3.50x11,31440
99283 Emergency department visit with low level of medical decision making9,92392.7%4.92x9,69231
81003 Automated urinalysis test2,06694.4%10.82x2,05332
85027 Complete blood cell count (red cells, white blood cell, platelets), automated te1,76594.7%9.98x1,75424
93010 Routine electrocardiogram (ECG) using at least 12 leads with interpretation and 1,41395.7%11.59x1,31931
87428 Detection test by immunoassay technique for severe acute respiratory syndrome co1,32893.3%11.09x1,31446
96374 Injection of drug or substance into vein1,21195.5%9.65x97134
96361 Infusion into a vein for hydration, each additional hour1,19795.0%6.75x1,18932
96375 Injection of additional new drug or substance into vein1,12295.2%9.42x90133
81025 Urine pregnancy test1,10693.3%6.46x1,10132.5
80048 Blood test, basic group of blood chemicals (Calcium, total)1,06894.8%6.91x1,05934
85025 Complete blood cell count (red cells, white blood cell, platelets), automated te1,06195.0%7.09x1,05348
82150 Amylase (enzyme) level1,03294.8%9.16x1,02632.5
93005 Routine electrocardiogram (ECG) using at least 12 leads with tracing1,02795.8%7.21x1,02132
80076 Liver function blood test panel98794.7%8.35x97733
82977 Glutamyltransferase (liver enzyme) level98495.5%7.85x97833
80053 Blood test, comprehensive group of blood chemicals86593.4%8.98x86031
71046 X-ray of chest, 2 views85295.2%8.36x84136
82947 Blood glucose (sugar) level82195.6%10.42x81433

2025 Q1–Q4 · rows with n ≥ 30 determined line items · sorted by n.

Related: all specialties in Oklahoma · Emergency medicine and emergency departments in all states

FAQ

What is the Federal IDR provider win rate for emergency medicine and emergency departments in Oklahoma?

In 2025 Q1–Q4, the provider or facility offer was selected in 93.4% of 90,054 determined dispute line items for emergency medicine and emergency departments in Oklahoma. Split decisions are excluded from the denominator and default decisions are included. Withdrawn, settled and ineligible disputes are not in the CMS data.

How do Federal IDR payments compare with the QPA for emergency medicine and emergency departments in Oklahoma?

In 2025 Q1–Q4, the median prevailing offer was 5.64x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 3.14x to 13.79x (n = 87,201 line items). This uses the CMS field Prevailing Party Offer as % of QPA, where 1.00x equals the QPA.

How long do Federal IDR decisions take for emergency medicine and emergency departments in Oklahoma?

In 2025 Q1–Q4, the median was 33 business days (n = 90,054 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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