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.

Convenient Care LLC (NPI 1164422630)

Key Findings

Field	Value
Entity Type	Organization
Organization	Convenient Care LLC
Address	12525 Perkins Rd
City	Baton Rouge
State	LA
ZIP	70810
Taxonomy	Urgent Care Clinic/Center
NPI Enumerated	July 27, 2005

Payer Source	Total Paid
Medicaid	$47.8M
Medicare	$0

CONVENIENT CARE LLC has no Medicare billing on file and is effectively a Medicaid-focused operator, reporting total Medicaid lifetime revenue of $47.8M. This single-payer profile means analyses of utilization and financial exposure should center on Medicaid reimbursement dynamics rather than Medicare comparators. The provider’s NPI was enumerated on 2005-07-27 (~21 years ago), indicating long-standing presence in the market.

Revenue is highly concentrated in a small set of outpatient evaluation-and-management codes: the top three Medicaid codes account for 78.1% of the provider’s total Medicaid revenue. Those top three codes are 99214 ($19.7M, 41.3%), 99213 ($11.5M, 24.0%), and 99203 ($6.1M, 12.8%), indicating the bulk of dollars come from routine E&M visits rather than high-revenue procedures or imaging.

The code mix and volumes point to an urgent care/retail clinic operating model that handles very high ambulatory visit volumes: 99214 (240.9K claims), 99213 (159.3K claims) and 99203 (75.3K claims) together dominate clinical activity. The presence of S9088 (119.1K claims, $1.2M) labeled for urgent care center services and multiple respiratory/COVID testing codes supports a walk-in, symptomatic-evaluation business with substantial throughput.

COMPETITIVE standing within Louisiana is dominant for key codes: 99214 ranks #6 of 2894 providers in-state (100th percentile; extreme outlier) and 99203 ranks #2 of 1283 providers in-state (100th percentile; extreme outlier), while 99213 ranks #20 of 3226 (99th percentile; extreme outlier). These rank and percentile positions indicate the provider is a major statewide volume leader for core urgent care E&M services and is far above typical state volumes for those codes.

Ancillary testing and low-acuity procedures generate meaningful volume though smaller revenue shares—examples include 87811 (93.9K claims, $1.4M, 2.9%; rank #3 of 303, 99th percentile; extreme outlier), 87635 (35.3K claims, $1.1M, 2.2%; rank #5 of 355, 99th percentile; extreme outlier), and 87804 (122.2K claims, $488.9K, 1.0%; rank #2 of 768, 100th percentile; extreme outlier). This pattern aligns with high-volume specimen testing and rapid diagnostics typical of urgent care centers during respiratory seasons.

Operational footprint appears to support extended hours and high visit throughput: the after-hours code 99051 shows 54.4K claims ($108.8K, 0.2%) and ranks #1 of 269 providers in-state (100th percentile; extreme outlier), suggesting significant evening/weekend or holiday service capacity relative to peers. Combined with the large counts for visit codes, this implies scheduling and staffing optimized for non-traditional clinic hours.

From a risk and payor-management perspective, the provider’s reliance on a narrow set of E&M codes (top three = 78.1% of Medicaid revenue) and absence of Medicare billing create concentration exposure to Medicaid policy, reimbursement changes, or state-level audit focus. Analysts should prioritize review of Medicaid billing patterns for 99214, 99213, and 99203 and monitor utilization drivers (high claim counts and testing volumes) when modeling revenue sensitivity or network negotiations.

Medicaid: Complete Services Breakdown

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

68 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…	240,850	$80	$19.7M
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…	159,330	$70	$11.5M
99203	The provider sees a new 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 provider…	75,260	$80	$6.1M
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…	37,570	$90	$3.5M
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…	93,860	$20	$1.4M
S9088	Services provided in an urgent care center (list in addition to code for service)	119,140	$10	$1.2M
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…	18,580	$60	$1.2M
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…	35,250	$30	$1.1M
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.	21,470	$30	$558.3K
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.	122,210	$1	$488.9K

Showing 1–10 of 68

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

Convenient Care LLC — 17 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

68 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…	6	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…	10	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…	20	3,230	1,120	$30	$204.3K
L4361	Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf	12	20	150	$150	$168.2K
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.	6	170	640	$30	$138.8K
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…	5	360	340	$30	$120.8K
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…	7	1,170	160	$80	$102.7K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	72	260	800	$10	$96.7K
10061	The provider incises the area of abscess and drains the collection of pus, such as those related to a carbuncle, hidradenitis, cyst, furuncle, or paronychia, with the help of surgical instruments. A…	4	10	40	$90	$96.3K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	34	700	180	$60	$77K

Showing 1–10 of 68

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pediatric Services Of America, LLC	LA	Nursing Care Agency	$0	$23.3M
Smilestars, LLC	LA	Pediatric Dentistry	$0	$16M
Gulf South Br - Aba, LLC	LA	Clinical Child & Adolescent Psychologist	$0	$8.8M
Dr Johnnie Lynn Hunt LLC	LA	Pediatric Dentistry	$0	$7.2M
Homedica Of Louisiana, LLC	LA	Case Manager/Care Coordinator	$0	$4.7M
Novamed Surgery Center Of Baton Rouge LLC	LA	Ambulatory Surgical Clinic/Center	$875.7K	$61.5K
Eric Oberlander	LA	Neurological Surgery Physician	$614.2K	$0
Charles Bowie	LA	Neurological Surgery Physician	$358.3K	$0
Daniel Naul	LA	Family Medicine Physician	$242.9K	$0
Reginald Griffith	LA	Orthopaedic Surgery Physician	$227K	$0

Convenient Care LLC — Billing Profile & Reimbursement Data

Sign up for Convenient Care LLC — Billing Profile & Reimbursement Data policy alerts

Convenient Care LLC — Billing Profile & Reimbursement Data

Sign up for Convenient Care LLC — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References