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    OpenPayerNPI Medicare & MedicaidPediatric Group LLC
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    Pediatric Group LLC — Billing Profile & Reimbursement Data

    NPI 1114129970 · Marion, IL · Rural Health Clinic/Center

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    Pediatric Group LLC is a rural health clinic/center provider located in Marion, Illinois. This profile covers 0 Medicare and 87 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationPediatric Group LLC
    Address3412 Office Park Drive
    CityMarion
    StateIL
    ZIP62959
    TaxonomyRural Health Clinic/Center
    NPI EnumeratedJune 4, 2007

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$13.7M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    87 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    T1015Clinic visit/encounter, all-inclusive163,620$80$13.6M
    90670This 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…10,840$1$21.7K
    90710This code represents an MMRV vaccine product administered beneath the skin to protect against measles, mumps, rubella (German measles), and varicella (chickenpox).5,080$1$15.3K
    90723The provider administers a combination inactivated vaccine intramuscularly to prevent multiple diseases, including diphtheria, tetanus, acellular pertussis, hepatitis B, and polio.7,620$1$7.6K
    90680This code represents a live pentavalent rotavirus vaccine given by mouth in a three–dose schedule to protect against rotavirus infection.6,840$1$6.8K
    99238The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…230$30$6.7K
    54150The provider performs a circumcision, a surgical procedure that removes the foreskin of the penis, using a clamp or other device and regional anesthesia consisting of a dorsal penile or ring block.80$70$5.3K
    99460The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.130$40$5.1K
    90734The provider administers a meningococcal conjugate vaccine in a diphtheria toxoid carrier (MenACWY–D) or CRM197 carrier (MenACWY–CRM) to protect the patient from four strains of meningococcal viruses…2,160$1$4.3K
    90686This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…4,310$1$4.3K

    Showing 1–10 of 87

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    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Illinois median

    87 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    T1015Clinic visit/encounter, all-inclusive298507,490$120$3.9M
    99214The 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…1614,680300$50$48.7K
    99392Preventive 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…81,380370$40$46.2K
    87811The 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…283550240$40$42.4K
    99391Preventive 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…81,270370$40$40.8K
    99213The 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…2614,190280$20$38.9K
    D1206Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients1621,300360$20$35.1K
    99393The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.171,670160$40$26.4K
    99394The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.341,590110$40$21.4K
    99349The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…62410170$30$19.1K

    Showing 1–10 of 87

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    Nearby Providers

    Other providers in the same ZIP code as Pediatric Group LLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Shawnee Health Service And Development CorpILFederally Qualified Health Center (FQHC)$0$6.8M
    Faisel AhmadILRetina Specialist (Ophthalmology) Physician$1.6M$4.1M
    Omar AhmadILRetina Specialist (Ophthalmology) Physician$2.9M$2.1M
    Advantage Nursing Services, Inc.ILNursing Care Agency$0$4.9M
    Heartland Pediatric ClinicILRural Health Clinic/Center$0$4.2M
    Centerstone Of Illinois, IncILMental Health Clinic/Center (Including Community Mental Health Center)$0$3.7M
    Heartland Women's Healthcare LtdILRural Health Clinic/Center$0$3.6M
    Marion Eye Centers Ltd.ILOphthalmology Physician$0$3.5M
    Williamson County Special EdILLocal Education Agency (LEA)$0$3.4M
    Michael SchifanoILObstetrics Physician$6.6K$1.5M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Illinois Providers
    7 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Illinois Distribution
    Pediatric Group LLC — 9 of 19 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Illinois