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

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

North Jefferson Pediatrics (NPI 1104012137)

North Jefferson Pediatrics is a specialist provider located in Gardendale, Alabama. This profile covers 0 Medicare and 40 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	North Jefferson Pediatrics
Address	934 Grubbs Ave
City	Gardendale
State	AL
ZIP	35071
Taxonomy	Specialist
NPI Enumerated	September 24, 2007

Payer Source	Total Paid
Medicaid	$1.8M
Medicare	$0

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

40 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…	16,510	$40	$594.2K
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…	4,930	$80	$375K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2,180	$60	$135.2K
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…	2,010	$70	$130.4K
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…	1,870	$70	$121.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1,680	$60	$104.3K
92081	The provider may use one or more methods to determine the extent of a patient's visual field of one or both eyes; he interprets the results and prepares a report. Report this code for a limited…	2,650	$30	$76.9K
92587	Code 92587 is in the Medicine/Special Otorhinolaryngologic Services Section. It involves special procedures of the ears/nose/throat. This code is for screening purposes with interpretation and…	2,140	$30	$70.7K
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	240	$180	$43.2K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	1,710	$20	$27.4K

Showing 1–10 of 40

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alabama Distribution

North Jefferson Pediatrics — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. Alabama median

40 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	67	100	470	$130	$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…	321	1,990	680	$60	$201.7K
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…	140	1,990	560	$40	$185.6K
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…	116	270	1,360	$60	$159.7K
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…	115	300	1,160	$50	$147.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	88	320	640	$50	$98.1K
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.	184	230	410	$40	$59.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	58	300	330	$50	$56.3K
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	113	260	910	$20	$47.2K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	125	160	1,080	$1	$46.7K

Showing 1–10 of 40

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Alignmed Partners, PC	AL	Geriatric Medicine (Internal Medicine) Physician	$0	$16.8M
Children And Teen Dental Group Of Alabama	AL	Pediatric Dentistry	$0	$2.1M
North Jefferson Pediatric Dentistry, LLC	AL	Pediatric Dentistry	$0	$1.5M
Andrew Ellard	AL	Physical Therapist	$185.4K	$0
Ryan Carlton	AL	Family Nurse Practitioner	$172.7K	$0
Ricky Tubbs	AL	Internal Medicine Physician	$132.8K	$0
Ashley Pauldin	AL	Family Nurse Practitioner	$109.9K	$0
Edward Tucker	AL	Psychiatric/Mental Health Nurse Practitioner	$102.2K	$0
Hali Mcdonald	AL	Nurse Practitioner	$80K	$0
Howard Day	AL	Optometrist	$34.2K	$0

North Jefferson Pediatrics — Billing Profile & Reimbursement Data

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North Jefferson Pediatrics — 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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References