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

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

Just 4 Kids Pediatrics (NPI 1366560971)

Key Findings

Field	Value
Entity Type	Organization
Organization	Just 4 Kids Pediatrics
Address	3067 Eagle Dr
City	Ammon
State	ID
ZIP	83406
Taxonomy	Pediatrics Physician
NPI Enumerated	March 26, 2007

Payer Source	Total Paid
Medicaid	$10.8M
Medicare	$0

JUST 4 KIDS PEDIATRICS is effectively a single‑payer Medicaid operation: there is no Medicare billing on file and the practice reports $10.8M in total Medicaid revenue, indicating Medicaid is the sole recorded federal payer driving its billed volume and revenue. This concentration in one payer should shape network, contracting, and utilization analyses.

Revenue is highly concentrated in a small group of preventive and office‑visit codes: the top three Medicaid codes (99213, 99392, 99393) account for 68.8% of this provider's total Medicaid revenue. 99213 alone generates $4.4M (41.0% of Medicaid revenue) from 67.2K claims, while 99392 and 99393 contribute $1.7M (15.4%) and $1.3M (12.4%) respectively, underlining dependence on routine E/M and well‑child services for the bulk of receipts.

The code mix and volumes show this is a high‑volume pediatric primary care and preventive practice. Large claim counts and revenue for well‑patient/preventive medicine codes (99392, 99393, 99391, 99394) plus very high vaccine administration activity (90471 with 37K claims, $665.8K revenue) are consistent with a clinic focused on well‑child visits, immunizations, and routine outpatient pediatric care. Operationally, staffing and scheduling will likely be optimized for frequent short preventive visits and vaccine workflows.

JUST 4 KIDS is a dominant statewide performer on multiple pediatric codes: 99213 ranks #8 of 669 providers in‑state (99th percentile; extreme outlier), 99392 ranks #2 of 79 (99th percentile; extreme outlier), and 99393 ranks #1 of 78 (100th percentile; extreme outlier). Several other codes also show exceptional statewide standing (for example 99394 and 99460 rank #1 in their provider pools), indicating the practice is a major in‑state provider for routine pediatric and newborn services rather than a modest participant.

Several immunization and diagnostic testing codes show unusually high volumes relative to peers, reinforcing the preventive‑care profile. 90471 (vaccine administration) is an extreme outlier in the state (#4 of 182, 98th percentile), while testing codes such as 87651 (Strep A) rank #4 of 42 (93rd percentile; notably above typical) and 87502 (multiplex influenza) rank #6 of 48 (89th percentile). These patterns point to substantial on‑site vaccination and rapid infectious‑disease testing capacity typical of high‑throughput pediatric clinics.

The provider’s ranking pattern includes a mix of extreme outliers and some codes with routine state‑level volumes, suggesting focused strengths rather than uniform dominance across all pediatric services. For example, 99214 is only at the 67th percentile statewide (#204 of 618), indicating less relative volume for higher‑complexity E/M visits even as low‑complexity established visit volume (99213) is exceptionally high. This implies a clinic model skewed toward high throughput of lower‑acuity, preventive encounters rather than complex chronic management.

The practice’s revenue and utilization profile creates concentration and policy sensitivity risk: with 68.8% of Medicaid revenue tied to three codes and 41.0% tied to 99213 alone, any changes in reimbursement, coding policy, or patient mix for routine E/M or well‑child services could disproportionately affect revenue. Payor negotiations and operational resilience planning should prioritize these high‑impact codes and the vaccination workflow that supports much of the ancillary revenue.

JUST 4 KIDS PEDIATRICS shows an established presence in the market with a long tenure: the NPI was enumerated on 2007-03-26 (~19 years ago). Combined with top rankings on multiple preventive and newborn codes, this tenure and volume profile suggests a mature, high‑capacity pediatric practice with a stable Medicaid focus and recognized statewide market position.

Medicaid: Complete Services Breakdown

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

52 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…	67,200	$70	$4.4M
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…	17,380	$100	$1.7M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	14,730	$90	$1.3M
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…	13,790	$90	$1.2M
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	36,990	$20	$665.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	5,930	$100	$598.5K
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…	2,000	$90	$176.3K
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…	1,590	$100	$157.6K
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.	4,330	$30	$138.7K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	9,080	$10	$99.8K

Showing 1–10 of 52

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Idaho Distribution

Just 4 Kids Pediatrics — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

52 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…	8	670	740	$40	$193.6K
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…	204	620	560	$60	$191.8K
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…	2	80	450	$80	$171.3K
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…	3	80	380	$70	$151.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1	80	130	$80	$91.4K
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…	6	50	210	$80	$51.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1	60	50	$70	$35.5K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	6	70	240	$20	$34.3K
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.	4	40	150	$30	$30.8K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	4	180	140	$10	$28.4K

Showing 1–10 of 52

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Royal Journeys LLC	ID	Developmentally Disabled Services Day Training Agency	$0	$38.3M
Qualicare Inc.	ID	Nursing Care Agency	$0	$10.3M
Pearl Health Clinic	ID	Mental Health Counselor	$0	$9.9M
4 Pillars Of Success LLC	ID	Multi-Specialty Clinic/Center	$0	$8M
A Childs Smile	ID	Pediatric Dentistry	$0	$4.4M
4 Pillars Of Success LLC	ID	Psychologist	$0	$3.3M
Lincare Inc.	ID	Durable Medical Equipment & Medical Supplies	$0	$2M
Darryl Moffett	ID	Ophthalmology Physician	$2M	$0
Idaho Falls Pediatric Dentistry, PLLC	ID	Pediatric Dentistry	$0	$1.2M
4 Pillars Of Success LLC	ID	Clinic/Center	$0	$697.9K

Just 4 Kids Pediatrics — Billing Profile & Reimbursement Data

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Just 4 Kids Pediatrics — 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

Nearby Providers

Frequently Asked Questions

References