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

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

Jefferson Pediatrics, Inc. (NPI 1336411347)

Jefferson Pediatrics, Inc. is a primary care clinic/center provider located in Jefferson, Georgia. This profile covers 0 Medicare and 25 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	Jefferson Pediatrics, Inc.
Address	2610 Highway 129 N
City	Jefferson
State	GA
ZIP	30549
Taxonomy	Primary Care Clinic/Center
NPI Enumerated	February 7, 2012

Payer Source	Total Paid
Medicaid	$785.5K
Medicare	$0

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

25 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…	5,470	$70	$366.7K
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…	1,290	$100	$123.7K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	2,600	$50	$119.4K
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…	1,010	$90	$92.5K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	3,060	$10	$21.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	140	$100	$13.3K
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.	750	$10	$10.4K
G0306	Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count	1,420	$10	$8.5K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	1,530	$10	$7.6K
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.	360	$10	$5.1K

Showing 1–10 of 25

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Georgia Distribution

Jefferson Pediatrics, Inc. — 1 of 18 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. Georgia median

25 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	158	920	370	$60	$360.6K
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…	658	820	390	$70	$245K
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…	77	180	680	$90	$226.7K
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…	78	180	720	$90	$204.2K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	87	250	660	$40	$172.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	122	170	500	$100	$170.6K
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…	260	310	90	$90	$136.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	146	160	190	$110	$129.7K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	99	140	940	$1	$82.1K
94640	The provider administers oxygen under pressure or not under pressure to open obstructed air passages. He uses any of the listed devices to treat a patient with an acute obstruction of the airway that…	77	80	190	$30	$49.9K

Showing 1–10 of 25

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jackson County B O C	GA	Land Ambulance	$783.1K	$0
Heather Pickelsimer	GA	Family Nurse Practitioner	$268.1K	$0
Jeffrey Curry	GA	Physical Therapist	$149.8K	$0
Jacob Flint	GA	Physical Therapist	$107.8K	$0
James Truby	GA	Registered Nurse	$23.5K	$0

Jefferson Pediatrics, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References