children’s psychiatric drugs in oklahoma medicaid: oklahoma’s own three numbers
oklahoma told cms three things about its children in the 2025 reporting year: 55.9 percent of children aged 1 to 11 newly prescribed an antipsychotic had psychosocial care documented first, 33rd of the 50 states that reported it; 15.9 percent of children on two or more antipsychotics got both the glucose and the cholesterol test, the fourth-lowest of the 49 states that reported it; 54.6 percent of children aged 6 to 12 starting an adhd medicine were seen again inside 30 days, 10th of the 51 states that reported it.[1]
across the whole age range, oklahoma sits in the top quarter of the country on the 30-day adhd follow-up and in the bottom quarter of the country on the two metabolic blood tests. same state, same year, same children.
every row oklahoma sent to cms
| measure | oklahoma | denominator | rank | national median |
|---|---|---|---|---|
| APP-CHpsychosocial care first, 1 to 11 | 55.9 | withheld | 33 of 50 | 59.2 |
| APP-CHpsychosocial care first, 12 to 17 | 55.7 | withheld | 42 of 51 | 63.8 |
| APP-CHpsychosocial care first, 1 to 17 | 55.7 | 2,824 | 42 of 51 | 61.4 |
| APM-CHboth blood tests, 1 to 11 | 15.9 | withheld | 46 of 49 | 29.1 |
| APM-CHboth blood tests, 12 to 17 | 22.5 | withheld | 47 of 51 | 36.3 |
| APM-CHboth blood tests, 1 to 17 | 19.9 | 8,724 | 47 of 51 | 32.9 |
| APM-CHglucose alone, 1 to 17 | 42.5 | 8,724 | 49 of 51 | 54.4 |
| APM-CHcholesterol alone, 1 to 17 | 20.6 | 8,724 | 47 of 51 | 34.8 |
| ADD-CH30-day adhd follow-up, 6 to 12 | 54.6 | 7,144 | 10 of 51 | 47.6 |
| ADD-CHnine-month adhd follow-up, 6 to 12 | 60.8 | 2,855 | 14 of 49 | 55.5 |
rank 1 is the highest rate. how the ranks and the withheld cells work.[1]
talking treatment before the antipsychotic
for the youngest children, aged 1 to 11, oklahoma reported 55.9 percent — 3.3 points below the national median of 59.2, and 33rd of the 50 states that reported it. put the other way round, 44.1 percent of the youngest children in oklahoma who were started on an antipsychotic had no psychosocial care documented before it. for adolescents aged 12 to 17 the figure was 55.7 percent. across ages 1 to 17, 55.7 percent on 2,824 children, 42nd of the 51 states that reported it. it reported 55.9 the year before on the same method, so this one moved 0.2 points down — the only one of the three where that comparison holds. either side of oklahoma on that row: utah at 56.6 and hawaii at 54.9.
the two blood tests
oklahoma reported that 15.9 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — the fourth-lowest of the 49 states that reported it, 13.2 points below the national median of 29.1. split into halves across ages 1 to 17, glucose ran 42.5 percent and cholesterol 20.6 percent, both on 8,724 children — the third-lowest of the 51 states that reported it on glucose, the fourth-lowest of the 51 states that reported it on cholesterol. across ages 1 to 17 the both-tests rate was 19.9 percent. either side of oklahoma on the both-tests row for ages 1 to 17: hawaii at 21.9 and idaho at 19.6.
the 30-day visit after a new adhd prescription
54.6 percent, on 7,144 children aged 6 to 12 who were newly prescribed an adhd medicine in oklahoma — 10th of the 51 states that reported it, 7.0 points above the national median of 47.6. that leaves 45.4 percent of those children with no recorded prescriber visit in the month after the medicine started. over the nine months that follow, 60.8 percent had at least two more visits on 2,855 children, against a national median of 55.5 — 14th of the 49 states that reported it. either side of oklahoma on the 30-day row: iowa at 55.1 and arkansas at 54.4.
what medicaid paid for in oklahoma in 2024
in 2024 medicaid in oklahoma paid for 114,391 hydroxyzine prescriptions, $1,379,926 worth, and 124,496 benzodiazepine prescriptions, $2,004,665 worth — 91.9 hydroxyzine prescriptions for every 100 benzodiazepine ones. 123 of the 493 hydroxyzine rows and 683 of the 1,758 benzodiazepine rows for oklahoma were suppressed, so both are floors.[2] our own sums of the federal file, which has no ages, so neither is a children’s number, and no rank.
four things to ask, with oklahoma’s own numbers behind them
ask which drug it is, not which class
oklahoma, 2024: 114,391 hydroxyzine prescriptions and 124,496 benzodiazepine prescriptions
hydroxyzine is an antihistamine; a benzodiazepine brings dependence and withdrawal. read the name on the bottle. why they get merged.
if an antipsychotic is being started, ask what came first
oklahoma: 55.9 percent of children aged 1 to 11, 33rd of the 50 states that reported it
in 44.1 percent of these cases the answer is “none yet”. ask what was tried first, and ask for it in the notes.
if your child is on an antipsychotic, get the date of the bloodwork
oklahoma: 15.9 percent of children aged 1 to 11 had both tests, the fourth-lowest of the 49 states that reported it
missed 84.1 percent of the time in oklahoma. ask when the glucose and cholesterol test is booked, and leave with a date.
if an adhd medicine has just been started, book the 30-day visit now
oklahoma: 54.6 percent, 10th of the 51 states that reported it
this is where a dose gets checked and a wrong fit is caught, and oklahoma misses it 45.4 percent of the time. book it before you leave the room.
how to read any of this
self-reported, on methods that differ by state, and process not outcome.[1] method and suppression rules; the national picture.
questions people ask
In Oklahoma, how many children get therapy before they get an antipsychotic?
In the 2025 reporting year Oklahoma reported 55.9 percent for children aged 1 to 11, against a national median of 59.2 percent — 33rd of the 50 states that reported it. For ages 12 to 17 it was 55.7 percent, and across ages 1 to 17 55.7 percent on 2,824 children.
In Oklahoma, do children on antipsychotics get the blood tests?
15.9 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — the fourth-lowest of the 49 states that reported it, against a national median of 29.1 percent. Across ages 1 to 17: glucose 42.5 percent, cholesterol 20.6 percent, on 8,724 children.
In Oklahoma, how often does the 30-day ADHD follow-up visit happen?
54.6 percent of the time, on 7,144 children aged 6 to 12 newly prescribed an ADHD medicine — 10th of the 51 states that reported it, against a national median of 47.6 percent. The nine-month measure, two further visits, was 60.8 percent in Oklahoma against a median of 55.5.
sources
- CMS Medicaid/CHIP Child Core Set, 2025 reporting year, Oklahoma rows, read 2026-09-28. APP-CH psychosocial care first, 1 to 11: 55.9 (denominator not publicly reported); APP-CH psychosocial care first, 12 to 17: 55.7 (denominator not publicly reported); APP-CH psychosocial care first, 1 to 17: 55.7 on a denominator of 2,824; APM-CH both blood tests, 1 to 11: 15.9 (denominator not publicly reported); APM-CH both blood tests, 12 to 17: 22.5 (denominator not publicly reported); APM-CH both blood tests, 1 to 17: 19.9 on a denominator of 8,724; APM-CH glucose alone, 1 to 17: 42.5 on a denominator of 8,724; APM-CH cholesterol alone, 1 to 17: 20.6 on a denominator of 8,724; ADD-CH 30-day adhd follow-up, 6 to 12: 54.6 on a denominator of 7,144; ADD-CH nine-month adhd follow-up, 6 to 12: 60.8 on a denominator of 2,855. Method and ranking scope: /medicaid-children. https://data.medicaid.gov/dataset/14bc26c3-5584-4032-9175-f3a0399cb206
- CMS State Drug Utilization Data 2024, Oklahoma rows, summed by product name, read 2026-09-28: hydroxyzine 114,391 prescriptions, $1,379,926, 123 of 493 rows suppressed; benzodiazepines 124,496 prescriptions, $2,004,665, 683 of 1,758 rows suppressed. Our sum, not a CMS statistic. https://data.medicaid.gov/dataset/61729e5a-7aa8-448c-8903-ba3e0cd0ea3c
all 51 states ranked · what the national numbers say
nothing here is a reason to start, stop or change a child’s medication. it is a set of questions to bring to the person who prescribes it.
adam