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

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

Pediatric Associates Of Southwest Missouri, LLC (NPI 1518083435)

Field	Value
Entity Type	Organization
Organization	Pediatric Associates Of Southwest Missouri, LLC
Address	2719 E 32nd St
City	Joplin
State	MO
ZIP	64804
Taxonomy	Pediatric Adolescent Medicine Physician
NPI Enumerated	March 22, 2007

Payer Source	Total Paid
Medicaid	$7.7M
Medicare	$0

Medicaid: Complete Services Breakdown

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

59 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…	73,040	$50	$3.9M
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…	10,730	$80	$825.8K
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…	10,660	$80	$809.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	7,970	$80	$605.3K
0241U	N/A	4,950	$110	$559.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	3,580	$70	$265K
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.	5,970	$30	$155.3K
90723	The provider administers a combination inactivated vaccine intramuscularly to prevent multiple diseases, including diphtheria, tetanus, acellular pertussis, hepatitis B, and polio.	4,820	$20	$110.8K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	1,200	$50	$59.8K
G0447	Face-to-face behavioral counseling for obesity, 15 minutes	4,190	$10	$54.5K

Showing 1–10 of 59

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

Pediatric Associates Of Southwest Missouri, LLC — 15 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

59 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
0241U	N/A	9	80	330	$110	$192.3K
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…	2,356	3,170	230	$70	$128.1K
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…	11	4,310	300	$60	$110.8K
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	43	50	130	$60	$82.7K
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	680	280	$90	$65.3K
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…	5	640	210	$90	$59.5K
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…	24	210	60	$80	$44.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	3	600	110	$90	$40.2K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	71	180	210	$30	$34.5K
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.	7	180	110	$30	$27.2K

Showing 1–10 of 59

Related Providers

Other providers that share a Tax Identification Number (TIN) with Pediatric Associates Of Southwest Missouri, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Teresa Crowe	KS	Pediatrics Physician	$0	$620.4K

Nearby Providers

Other providers in the same ZIP code as Pediatric Associates Of Southwest Missouri, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ozark Center	MO	Community/Behavioral Health Agency	$0	$165.3M
Jasper County Sheltered Facilities Assoc	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$62.1M
Mercy Hospital Joplin	MO	General Acute Care Hospital	$0	$46.7M
The Arc Of The Ozarks	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$44.5M
Freeman-oak Hill Health System	MO	General Acute Care Hospital	$0	$33.2M
The Independent Living Center, Inc.	MO	Attendant Care Provider	$0	$24.7M
Jasper County Sheltered Facilities Board	MO	Case Management Agency	$0	$21.3M
Mercy Clinic Joplin LLC	MO	Family Medicine Physician	$0	$20.4M
Freeman-oak Hill Health System	MO	Multi-Specialty Clinic/Center	$0	$14.7M
Jasper County Sheltered Facilities Assoc	MO	Developmentally Disabled Services Day Training Agency	$0	$13.2M

Pediatric Associates Of Southwest Missouri, LLC — Billing Profile & Reimbursement Data

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Pediatric Associates Of Southwest Missouri, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References