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.

Pediatric Group Of Acadiana, LLC (NPI 1265499628)

Key Findings

Field	Value
Entity Type	Organization
Organization	Pediatric Group Of Acadiana, LLC
Address	401 Youngsville Hwy
City	Lafayette
State	LA
ZIP	70508
Taxonomy	Specialist
NPI Enumerated	April 28, 2006

Payer Source	Total Paid
Medicaid	$57.5M
Medicare	$0

PEDIATRIC GROUP OF ACADIANA, LLC is effectively a Medicaid-focused provider: it has no Medicare billing on file while reporting $57.5M in lifetime Medicaid revenue, indicating its business is concentrated almost entirely on pediatric care reimbursed by Medicaid. The absence of Medicare activity makes this an effectively single-payer (Medicaid) operation for the observed data set.

Revenue concentration is highly focused within a small set of services: the precomputed note states the top 3 Medicaid codes by revenue account for 45.8% of the provider’s total Medicaid revenue. This suggests a heavy reliance on a narrow set of outpatient E/M and preventive care codes that drive nearly half of all Medicaid dollars for this entity.

The code mix and volumes identify this practice as a high-volume pediatric primary care and preventive services operation. High-ranking codes such as 99213, 99214, and 99212 together represent large volume office visits for established patients, while preventive codes 99392, 99391, 99393, and 99394 indicate a major emphasis on well-child and adolescent periodic exams; vaccination administration codes 90471/90472 further support routine immunization delivery as a core service line.

This provider is a statewide dominant outlier on many common pediatric codes: 99213 ranks #6 of 3226 providers (100th percentile, described as an extreme outlier), 99212 ranks #5 of 1461 (100th percentile, extreme outlier), and 99214 ranks #20 of 2894 (99th percentile). Preventive visit codes 99392, 99391, 99393, and 99394 are all at or near #1–#2 statewide (100th percentile for most), which collectively signals a market-leading position in pediatric well visits across Louisiana.

Service mix includes higher-acuity components alongside routine care: in addition to large volumes of low-to-moderate E/M visits, the provider reports notable revenue from procedural and diagnostic items tied to pediatrics—examples include circumcision 54150 (ranks #1 of 47, 100th percentile), echocardiography 93303/93320, and allergen testing/treatment codes 95004 and 95165 (95004 ranks #1 of 51, 100th percentile). These codes indicate the practice either performs a range of in-office procedures or coordinates high-volume outpatient testing as part of its pediatric services.

High-volume preventive and vaccination activity is evident in detailed code-level counts: vaccination administration 90471 (135.4K claims) and subsequent-dose 90472 (84.7K claims) are large contributors, and influenza testing 87502 (22.1K claims) and hearing screens 92551 (105.3K claims) further illustrate a broad preventive-population workload. The provider’s payments per claim on many of these codes are modest, so volume rather than high unit prices appears to drive total Medicaid revenue.

Tenure in the NPI registry is substantial: the provider was enumerated on 2006-04-28 (approximately 20 years ago), indicating long-standing presence in the market. This longevity combined with the extreme-volume rankings suggests an established regional practice with persistent, high-volume pediatric patient flow.

Several codes are statistical outliers at the statewide level, described in the source as “extreme outlier” or equivalent language for multiple high-volume codes (for example, 99213, 99212, 99392, 99391, 99393, 99394, 90471/90472, 95004). These labels, together with top-rank positions, characterize the provider as operating far above typical state volume for core pediatric services rather than a modest or average participant.

Medicaid: Complete Services Breakdown

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

202 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…	325,890	$40	$14M
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…	95,460	$60	$5.3M
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,…	168,630	$30	$4.2M
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…	65,670	$60	$4.1M
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…	62,290	$60	$3.6M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	54,470	$60	$3.4M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	40,590	$70	$2.7M
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	135,410	$10	$1.8M
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…	22,080	$70	$1.6M
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	6,100	$230	$1.4M

Showing 1–10 of 202

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

Pediatric Group Of Acadiana, LLC — 19 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

202 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	364	810	4,280	$110	$1.8M
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	3	30	2,260	$110	$460.1K
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…	20	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…	8	210	630	$70	$239.6K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	89	190	660	$70	$234.9K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	1	50	210	$200	$206K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	69	150	340	$120	$204.6K
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…	6	3,230	1,120	$30	$204.3K
0241U	N/A	15	100	430	$90	$186.2K
93325	The provider performs Doppler echocardiography, a diagnostic procedure based on the Doppler effect of sound, color flow velocity mapping, a two–dimensional image representation of blood flow in the…	5	30	1,290	$30	$172.6K

Showing 1–10 of 202

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pediatric Group Of Acadiana, LLC	LA	Rural Health Clinic/Center	$0	$7.9M
Pediatric Group Of Acadiana LLC	LA	Rural Health Clinic/Center	$0	$5.6M
Sai Chennamsetty	LA	Internal Medicine Physician	$582.4K	$0
Himani Reddy Manthena	LA	Internal Medicine Physician	$128.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Acadian Ambulance Service, Inc.	LA	Air Ambulance	$38.7M	$422.7M
Leading Health Care Of La	LA	In Home Supportive Care Agency	$0	$57.4M
Our Lady Of Lourdes Regional Medical Center, Inc	LA	General Acute Care Hospital	$0	$54.3M
Sleep Management, L.L.C.	LA	Oxygen Equipment & Supplies (DME)	$0	$41.8M
Medi Trans, LLC	LA	Transportation Broker	$0	$29.8M
L & D Community Care, Inc	LA	In Home Supportive Care Agency	$0	$24.4M
Acadiana Acute Care Associates, LLC	LA	Emergency Medicine Physician	$0	$20.4M
Lourdes After Hours LLC	LA	Urgent Care Clinic/Center	$0	$20.2M
Laboratory Corporation Of America	LA	Clinical Medical Laboratory	$1.9M	$12.4M
Leading Health Care Of La	LA	In Home Supportive Care Agency	$0	$12.8M

Pediatric Group Of Acadiana, LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References