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

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

Southern Indiana Pediatrics, LLC (NPI 1417921933)

Southern Indiana Pediatrics, LLC is a pediatrics physician provider located in Bloomington, Indiana. This profile covers 0 Medicare and 63 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	Southern Indiana Pediatrics, LLC
Address	350 S Landmark Ave
City	Bloomington
State	IN
ZIP	47403
Taxonomy	Pediatrics Physician
NPI Enumerated	February 13, 2006

Payer Source	Total Paid
Medicaid	$10.7M
Medicare	$0

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

63 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…	87,690	$50	$4.5M
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…	21,740	$70	$1.5M
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…	15,590	$80	$1.2M
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…	14,180	$80	$1.2M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	7,330	$80	$600.9K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	43,760	$10	$437.6K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	24,240	$20	$412.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,900	$80	$231.6K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	4,490	$30	$143.7K
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…	27,490	$10	$137.4K

Showing 1–10 of 63

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Indiana Distribution

Southern Indiana Pediatrics, LLC — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. Indiana median

63 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	533	580	710	$60	$582.9K
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…	130	2,120	870	$60	$450.6K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	528	690	1,070	$80	$422.3K
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…	32	2,380	920	$50	$376.8K
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	8	20	250	$100	$344.7K
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	15	20	250	$100	$308.8K
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…	10	280	880	$80	$267.2K
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…	14	290	770	$80	$250.8K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	263	270	470	$30	$171.9K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	155	200	540	$60	$167.3K

Showing 1–10 of 63

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Centerstone Of Indiana, Inc.	IN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$318.8M
Limestone Health, LLC	IN	Methadone Clinic	$116.1K	$9M
Prime Healthcare Services - Monroe LLC	IN	General Acute Care Hospital	$0	$5.7M
Hands At Home, LLC	IN	Home Health Agency	$0	$4.1M
Bloomington Pediatric Dentistry L.L.C.	IN	Pediatric Dentistry	$0	$3.1M
Integ Health System, P.C.	IN	Ambulatory Surgical Clinic/Center	$1.8M	$403.1K
Joseph Mackey	IN	Ophthalmology Physician	$2M	$0
Southern Indiana Surgery Center, LLC	IN	Ambulatory Surgical Clinic/Center	$1.4M	$516.1K
Warren Chang	IN	Ophthalmology Physician	$1.5M	$0
Bloomington Advanced Surgery Center, LLC	IN	Ambulatory Surgical Clinic/Center	$1.1M	$0

Southern Indiana Pediatrics, LLC — Billing Profile & Reimbursement Data

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Southern Indiana 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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