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.

Professional Pediatrics, LLC (NPI 1376717959)

Professional Pediatrics, LLC is a rural health clinic/center provider located in Leesville, Louisiana. This profile covers 0 Medicare and 77 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	Professional Pediatrics, LLC
Address	919 S 10th St
City	Leesville
State	LA
ZIP	71446
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	April 15, 2008

Payer Source	Total Paid
Medicaid	$10.1M
Medicare	$0

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

77 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	103,110	$70	$7.4M
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…	33,970	$30	$849.2K
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…	78,110	$10	$468.7K
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…	6,500	$30	$175.6K
99051	The provider sees a patient during regular office hours that occur outside of traditional office hours, i.e., in the evening, on a weekend, or on a holiday.	14,120	$10	$169.4K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	540	$230	$126.1K
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…	2,250	$60	$123.5K
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…	5,140	$20	$113K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	4,570	$20	$105.1K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	16,010	$10	$80K

Showing 1–10 of 77

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

Professional Pediatrics, LLC — 6 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

77 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	20	810	4,280	$110	$1.8M
H2020	Therapeutic behavioral services, per diem	309	320	2,270	$90	$637.8K
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…	80	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…	58	210	630	$70	$239.6K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	29	50	210	$200	$206K
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…	53	3,230	1,120	$30	$204.3K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	21	50	400	$150	$168.8K
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…	37	360	780	$50	$141.5K
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…	34	420	740	$50	$137.3K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	154	270	3,140	$10	$111K

Showing 1–10 of 77

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Clhg-leesville	LA	General Acute Care Hospital	$0	$16.3M
Great River Orthopedic And Sports Medicine Center, Inc.	LA	Orthopaedic Surgery Physician	$0	$11.8M
Allstar Pediatrics	LA	Primary Care Clinic/Center	$0	$8.7M
Carlock Enterprises LLC	LA	Rural Health Clinic/Center	$0	$4.6M
Jose Mathew	LA	Cardiovascular Disease Physician	$414.8K	$0
Gregory Lord	LA	General Practice Physician	$379.3K	$0
Kanchan Upadhyay	LA	Hematology & Oncology Physician	$332.8K	$840
Joe Rankin	LA	Diagnostic Radiology Physician	$145.3K	$0
Decora Franklin	LA	Nurse Practitioner	$100.3K	$0
Oluwayemisi Ojemakinde	LA	Diagnostic Radiology Physician	$87.6K	$0

Professional 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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References