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

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

Joint Heirs Pediatrics LLC (NPI 1164859880)

Joint Heirs Pediatrics LLC is a pediatrics physician provider located in Kokomo, Indiana. This profile covers 0 Medicare and 56 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	Joint Heirs Pediatrics LLC
Address	419 E Lincoln Rd
City	Kokomo
State	IN
ZIP	46902
Taxonomy	Pediatrics Physician
NPI Enumerated	September 27, 2013

Payer Source	Total Paid
Medicaid	$12M
Medicare	$0

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

56 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…	61,060	$60	$3.6M
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…	26,110	$90	$2.2M
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…	14,930	$80	$1.2M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	10,900	$80	$915.4K
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,…	22,840	$40	$868.1K
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…	10,120	$80	$829.4K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	17,090	$30	$461.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	4,570	$90	$388K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	25,930	$10	$337.1K
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.	19,720	$10	$276.1K

Showing 1–10 of 56

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Indiana Distribution

Joint Heirs Pediatrics LLC — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. Indiana median

56 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…	110	2,120	870	$60	$450.6K
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…	55	2,380	920	$50	$376.8K
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…	22	280	880	$80	$267.2K
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…	12	290	770	$80	$250.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	7	320	310	$80	$133.9K
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…	54	160	740	$60	$119.1K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	22	390	990	$20	$74.5K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	130	290	130	$40	$69.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	11	290	160	$80	$67.3K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	68	90	110	$70	$59.2K

Showing 1–10 of 56

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hopebridge, LLC	IN	Child & Adolescent Psychiatry Physician	$0	$140.4M
Community Howard Regional Health, Inc	IN	General Acute Care Hospital	$0	$25.5M
Bona Vista Programs, Inc.	IN	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$17.5M
Community Howard Regional Health, Inc	IN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$14.9M
Community Howard Regional Health Inc	IN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8.7M
Indiana Health Centers, Inc.	IN	Federally Qualified Health Center (FQHC)	$0	$8.6M
Ladd Dental Group Inc	IN	General Practice Dentistry	$0	$6.1M
Kokomo Pediatric Dentistry, LLC	IN	Public Health Dentistry	$0	$5.5M
Autism Brain Alternatives, Inc	IN	Behavior Analyst	$0	$4.4M
Comfort Home Health, LLC	IN	Home Health Agency	$0	$4.3M

Joint Heirs Pediatrics LLC — Billing Profile & Reimbursement Data

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Joint Heirs 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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