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 Kentucky for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Kentucky 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. Kentucky (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.

Eastern Kentucky Tender Care Pediatrics LLC (NPI 1043437254)

Eastern Kentucky Tender Care Pediatrics LLC is a rural health clinic/center provider located in Prestonsburg, Kentucky. This profile covers 0 Medicare and 76 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	Eastern Kentucky Tender Care Pediatrics LLC
Address	400 University Dr Ste 101
City	Prestonsburg
State	KY
ZIP	41653
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	April 19, 2007

Payer Source	Total Paid
Medicaid	$5.2M
Medicare	$0

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

76 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	90,580	$30	$2.9M
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	10,930	$40	$404.5K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	5,660	$60	$350.7K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	4,810	$60	$288.4K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	21,620	$10	$281K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	3,740	$60	$213K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	13,030	$10	$182.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1,600	$60	$100.9K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	2,020	$40	$76.6K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	1,890	$30	$64.1K

Showing 1–10 of 76

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Kentucky providers billing the same CPT/HCPCS codes.

Claims Volume vs. Kentucky Distribution

Eastern Kentucky Tender Care Pediatrics LLC — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

76 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	51	3,340	1,020	$30	$296K
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…	883	2,460	580	$40	$245K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	184	600	600	$40	$207.8K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	40	230	720	$60	$180.1K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	27	260	540	$70	$176.6K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	240	310	3,500	$10	$149.9K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	29	400	800	$30	$113.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	24	320	180	$70	$79.9K
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…	938	1,020	120	$70	$62K
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,…	447	1,450	270	$30	$61K

Showing 1–10 of 76

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Whitney Nelson	KY	Family Nurse Practitioner	$670	$0
Bethany Pennington	KY	Family Nurse Practitioner	$270	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mountain Comprehensive Care Center, Inc.	KY	Mental Health Counselor	$0	$243M
Mountain Comprehensive Care Center	KY	Case Management Agency	$0	$65.1M
Big Sandy Area Agency On Aging	KY	Supports Brokerage Agency	$0	$56.2M
Arh Tug Valley Health Services, Inc.	KY	General Acute Care Hospital	$0	$33.8M
Highlands Hospital Corp	KY	Cardiovascular Disease Physician	$0	$15.9M
Jt Associates, Inc	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$7.6M
Commonwealth Counseling Centers LLC	KY	Substance Abuse Rehabilitation Facility	$0	$7.1M
Alan Hyden	KY	Pediatric Dentistry	$0	$6.4M
East Kentucky Rehabilitation Center	KY	Substance Use Disorder Rehabilitation Clinic/Center	$0	$6M
Floyd Emergency Group, LLC	KY	Emergency Medicine Physician	$0	$4.2M

Eastern Kentucky Tender Care Pediatrics LLC — Billing Profile & Reimbursement Data

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Eastern Kentucky Tender Care Pediatrics 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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