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.

Pediatria Healthcare LLC (NPI 1407922800)

Field	Value
Entity Type	Organization
Organization	Pediatria Healthcare LLC
Address	5185 Peachtree Pkwy
City	Norcross
State	GA
ZIP	30092
Taxonomy	Nursing Care Agency
NPI Enumerated	November 28, 2006

Payer Source	Total Paid
Medicaid	$11.1M
Medicare	$0

Key Findings

PEDIATRIA HEALTHCARE LLC has no Medicare billing on file and is effectively a single-payer Medicaid provider, reporting $11.1M in lifetime Medicaid revenue. The absence of Medicare activity means comparisons or revenue diversification across federal payers cannot be evaluated for this entity.

Revenue is highly concentrated in a very narrow set of home nursing codes: the precomputed top-3 Medicaid codes account for 100.0% of this providers Medicaid revenue, with S9124 and S9123 collectively representing the entirety of reported Medicaid receipts. This concentration indicates the business is built almost exclusively around Medicaid-funded in-home nursing services.

S9124 (Nursing care, in the home; by licensed practical nurse, per hour) is the dominant single code by dollars for this provider: 24.7K claims, $332 avg paid/claim, $8.2M revenue, comprising 74.0% of the providers Medicaid revenue. The claim volume and per-hour payment level show the organization is delivering high-volume hourly LPN services billed to Medicaid.

S9123 (Nursing care, in the home; by registered nurse, per hour) is the secondary revenue driver with 9.5K claims, $304 avg paid/claim, $2.9M revenue, accounting for 26.0% of Medicaid revenue. The presence of both RN and LPN hourly codes implies staffing mix that includes both licensed practical nurses and registered nurses providing in-home care.

Both S9124 and S9123 rank #2 of 5 providers in-state and are placed at the 75th percentile, described in the source as "typical, unremarkable volume for this code." This positioning indicates the provider is a solid regional participant with above-median volume but not a dominant statewide leader for these in-home nursing services.

The providers business model appears specialized toward recurring, hourly in-home nursing care rather than episodic procedural services; sustaining revenue therefore likely depends on maintaining staffing capacity and Medicaid authorization for ongoing home care. High reliance on per-hour reimbursement for nursing labor could make financial performance sensitive to wage pressure or Medicaid rate changes.

Operationally, the counts and averages (24.7K claims at $332 avg for S9124; 9.5K claims at $304 avg for S9123) point to an operational footprint focused on routine, repeated visits rather than infrequent high-dollar procedures. Analysts evaluating contracting or audits should expect a service delivery pattern dominated by frequent, hour-based home nursing encounters.

The NPI has been enumerated since 2006-11-28 (~20 years ago), indicating long tenure in the market; longevity combined with concentrated Medicaid volume suggests an established Medicaid-focused home nursing agency rather than a new entrant or diversified multi-payer operator.

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S9124	Nursing care, in the home; by licensed practical nurse, per hour	24,680	$330	$8.2M
S9123	Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)	9,460	$300	$2.9M

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

Pediatria Healthcare LLC — 0 of 2 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

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S9124	Nursing care, in the home; by licensed practical nurse, per hour	2	10	140	$350	$3.8M
S9123	Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)	2	10	7,030	$170	$992.1K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Pediatria Healthcare LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pediatria Healthcare, LLC	MA	Home Health Agency	$0	$47.8M
Pediatria Healthcare, LLC	PA	Medically Fragile Infants and Children Day Care	$0	$14M
Pediatria Healthcare, LLC	PA	Home Health Agency	$0	$13.9M
Pediatria Healthcare, LLC	LA	Medically Fragile Infants and Children Day Care	$0	$9.8M

Nearby Providers

Other providers in the same ZIP code as Pediatria Healthcare LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
La Clinica Del Nino PC	GA	Pediatrics Physician	$0	$7.7M
Advanced Medical Diagnostics Of Texas, LLC	GA	Clinical Medical Laboratory	$2.9M	$1.4K
Oxy-gen Laboratory LLC	GA	Clinical Medical Laboratory	$77.4K	$1.1M
Alpha Genomix Laboratories Inc	GA	Clinical Medical Laboratory	$0	$1.1M
Rishi Singhal	GA	Retina Specialist (Ophthalmology) Physician	$668.8K	$0
Sam Daliri	GA	General Practice Dentistry	$0	$648.5K
Galina Vayner	GA	Internal Medicine Physician	$477.3K	$0
Atlas Ambulance Inc	GA	Land Ambulance	$458.1K	$0
Kendra Cole	GA	Specialist	$236.1K	$0
Purnima Patel	GA	Ophthalmology Physician	$200.9K	$0

Pediatria Healthcare LLC — Billing Profile & Reimbursement Data

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Pediatria Healthcare 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