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.

Lincoln Pediatrics (NPI 1447404546)

Lincoln Pediatrics is a pediatrics physician provider located in La Porte, Indiana. This profile covers 0 Medicare and 41 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	Lincoln Pediatrics
Address	414 Lincolnway
City	La Porte
State	IN
ZIP	46350
Taxonomy	Pediatrics Physician
NPI Enumerated	November 17, 2008

Payer Source	Total Paid
Medicaid	$3.3M
Medicare	$0

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

41 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…	25,200	$60	$1.4M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	4,350	$90	$370.1K
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…	4,450	$80	$364.6K
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…	4,600	$80	$354.4K
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…	2,930	$80	$222.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,370	$80	$199.2K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	7,540	$10	$90.5K
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,…	2,110	$30	$63.4K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	6,580	$10	$52.7K
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.	1,950	$10	$25.4K

Showing 1–10 of 41

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

Lincoln Pediatrics — 2 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

41 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	640	2,120	870	$60	$450.6K
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…	157	2,380	920	$50	$376.8K
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…	53	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…	58	290	770	$80	$250.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	35	320	310	$80	$133.9K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	141	190	190	$50	$90.2K
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…	769	890	160	$60	$76.8K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	58	390	990	$20	$74.5K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	269	290	130	$40	$69.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	25	290	160	$80	$67.3K

Showing 1–10 of 41

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
La Porte Hospital Company LLC	IN	General Acute Care Hospital	$0	$20.9M
Centers For Pain Control, Inc	IN	Pain Medicine Physician	$0	$8.1M
North Indiana Emergency Physicians, LLP	IN	Emergency Medicine Physician	$0	$7M
La Porte County Auditor	IN	Land Ambulance	$1M	$4.8M
Valerie Weber	IN	Mental Health Counselor	$0	$5.2M
Beacon Medical Group, Inc.	IN	Family Medicine Physician	$0	$3.4M
Thomas Allen	IN	Health Service Psychologist	$33.2K	$1.4M
Jennifer Alderink	IN	Family Medicine Physician	$981.7K	$0
Sayuri Cheruvu	IN	Medical Oncology Physician	$934.1K	$0
Interventional Pain Management LLC	IN	Ambulatory Surgical Clinic/Center	$182.1K	$444.5K

Lincoln Pediatrics — Billing Profile & Reimbursement Data

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Lincoln Pediatrics — 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