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

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

Lily Pad Pediatrics, LLC (NPI 1073969531)

Lily Pad Pediatrics, LLC is a rural health clinic/center provider located in Opelousas, Louisiana. This profile covers 0 Medicare and 84 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	Lily Pad Pediatrics, LLC
Address	153 Town Boulevard
City	Opelousas
State	LA
ZIP	70570
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	May 13, 2016

Payer Source	Total Paid
Medicaid	$10.7M
Medicare	$0

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

84 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…	60,840	$60	$3.7M
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…	42,720	$40	$1.7M
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…	12,060	$60	$771.6K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	10,600	$60	$667.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	9,280	$70	$603K
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…	9,560	$60	$573.4K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	19,100	$30	$515.7K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	4,500	$70	$319.4K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	23,550	$10	$306.2K
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,…	11,960	$30	$299K

Showing 1–10 of 84

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Louisiana Distribution

Lily Pad Pediatrics, LLC — 13 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Louisiana

Full comparison — all codes billed, vs. Louisiana median

84 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…	40	2,890	980	$40	$246.8K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	23	210	630	$70	$239.6K
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…	123	3,230	1,120	$30	$204.3K
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…	21	360	780	$50	$141.5K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	9	170	640	$30	$138.8K
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…	19	420	740	$50	$137.3K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	62	360	340	$30	$120.8K
99499	Use 99499 to report evaluation and management services for which there is no specific code available.	10	60	160	$120	$99.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	20	490	310	$50	$84.7K
87634	The lab analyst performs a test for respiratory syncytial virus (RSV) antigen detection using amplified nucleic acid probe technique.	7	70	170	$50	$81.8K

Showing 1–10 of 84

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Opelousas General Hospital Authority	LA	General Acute Care Hospital	$0	$27.2M
Agape Total Care LLC	LA	Personal Care Attendant	$0	$19.1M
Southern Home Care Services, Inc.	LA	Intellectual Disabilities Intermediate Care Facility	$0	$10.6M
Opelousas Emergency Group LLC	LA	Emergency Medicine Physician	$0	$10M
Agape Total Care LLC	LA	Personal Care Attendant	$0	$9M
Louisiana Home Healthcare Partners, LLC	LA	Home Health Agency	$0	$8.9M
Southwest Louisiana Primary Health Care Center, Inc	LA	Federally Qualified Health Center (FQHC)	$0	$8M
Opelousas Dental LLC	LA	General Practice Dentistry	$0	$7.6M
Jodison Prime Care, LLC	LA	Community Based Hospice Care Agency	$0	$6.5M
St Landry Ems	LA	Ambulance	$839.2K	$5.3M

Lily Pad Pediatrics, LLC — Billing Profile & Reimbursement Data

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Lily Pad 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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Frequently Asked Questions

References