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.

Physician Practice Partners (NPI 1326598434)

Physician Practice Partners is a internal medicine physician provider located in Houma, Louisiana. This profile covers 0 Medicare and 70 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	Physician Practice Partners
Address	8166 Main St
City	Houma
State	LA
ZIP	70360
Taxonomy	Internal Medicine Physician
NPI Enumerated	October 12, 2016

Payer Source	Total Paid
Medicaid	$7.4M
Medicare	$0

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

70 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	53,730	$70	$3.5M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	16,120	$80	$1.3M
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…	23,480	$30	$680.9K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	18,390	$40	$662K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	7,210	$30	$180.3K
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…	6,000	$30	$156.1K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	35,050	$1	$140.2K
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…	1,720	$80	$131K
99238	The 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…	2,360	$50	$120.1K
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…	1,640	$60	$98.3K

Showing 1–10 of 70

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

Physician Practice Partners — 1 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

70 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	35	270	9,980	$110	$2.6M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	76	240	4,030	$130	$2M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	91	270	11,250	$90	$1.8M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	16	20	1,890	$280	$1M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	72	170	1,260	$70	$322.4K
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…	126	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…	156	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…	152	190	660	$70	$234.9K
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…	36	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…	741	3,230	1,120	$30	$204.3K

Showing 1–10 of 70

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Louisiana State University School Of Med In New Orleans Faculty Grou	LA	Pediatrics Physician	$0	$43M
William Ladd	LA	Cardiovascular Disease Physician	$682.3K	$0
Pradeep Nair	LA	Interventional Cardiology Physician	$649.3K	$0
Vinod Nair	LA	Interventional Cardiology Physician	$596.4K	$0
Genevieve Maronge	LA	Internal Medicine Physician	$590.6K	$0
Richard Abben	LA	Interventional Cardiology Physician	$573.4K	$0
Craig Walker	LA	Interventional Cardiology Physician	$508.6K	$0
Maurice King	LA	Radiation Oncology Physician	$491.2K	$0
Shane Prejean	LA	Advanced Heart Failure and Transplant Cardiology Physician	$403K	$0
Peter Fail	LA	Advanced Heart Failure and Transplant Cardiology Physician	$346K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Physicians Group Laboratories, LLC	LA	Clinical Medical Laboratory	$886.8K	$208.1M
Start Corporation	LA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$45.3M
Cardiovascular Institute Of The South, LLC	LA	Cardiovascular Disease Physician	$0	$32.6M
Ascent Health, Inc	LA	Community/Behavioral Health Agency	$0	$16.3M
Terrebonne Parish Hospital Service District #1	LA	General Acute Care Hospital	$0	$16.1M
Start Corporation	LA	Federally Qualified Health Center (FQHC)	$0	$15.6M
Gulf Coast Teaching Family Services, Inc.	LA	Community/Behavioral Health Agency	$0	$13M
Teche Action Board, Inc.	LA	Federally Qualified Health Center (FQHC)	$0	$11M
1st A Southeast Incs, LLC	LA	Point of Service	$0	$9.3M
Bayou Pediatric Associates, Apmc	LA	Pediatrics Physician	$0	$7.9M

Physician Practice Partners — Billing Profile & Reimbursement Data

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Physician Practice Partners — 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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