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

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Wilkes Pediatric Clinic, PLLC (NPI 1659487502)

Wilkes Pediatric Clinic, PLLC is a pediatrics physician provider located in North Wilkesboro, North Carolina. 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	Wilkes Pediatric Clinic, PLLC
Address	1925 W Park Dr
City	North Wilkesboro
State	NC
ZIP	28659
Taxonomy	Pediatrics Physician
NPI Enumerated	August 22, 2006

Payer Source	Total Paid
Medicaid	$14.2M
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…	80,050	$70	$5.3M
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…	20,870	$100	$2.1M
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…	9,650	$90	$888K
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…	8,980	$100	$880.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	8,340	$100	$825.4K
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	191,870	$1	$575.6K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	5,340	$100	$555.3K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	15,800	$30	$505.4K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	24,140	$20	$482.8K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	9,630	$40	$356.2K

Showing 1–10 of 63

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Carolina Distribution

Wilkes Pediatric Clinic, PLLC — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

63 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	182	2,850	10,910	$10	$330.3K
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…	175	4,400	960	$60	$271.3K
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…	43	520	1,080	$80	$262.1K
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…	45	550	970	$90	$258.9K
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…	26	4,130	670	$50	$219.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	33	590	490	$90	$179.8K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	269	330	300	$10	$142.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	27	530	270	$90	$112.8K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	26	630	840	$30	$101.2K
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.	223	570	190	$70	$92.9K

Showing 1–10 of 63

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Life Alliance, LLC	NC	Community/Behavioral Health Agency	$0	$38.2M
Ats Of North Carolina, LLC	NC	Methadone Clinic	$271.6K	$11.5M
Wrmc Hospital Operating Corporation	NC	General Acute Care Hospital	$0	$9.5M
Addus Healthcare (south Carolina), Inc.	NC	Case Manager/Care Coordinator	$0	$7.2M
Steven Anderson	NC	Orthopaedic Surgery Physician	$473.6K	$0
Tolulola Adeola	NC	Hospitalist Physician	$191K	$0
John Mclarney	NC	Diagnostic Radiology Physician	$152.9K	$0
Gregory Evans	NC	Diagnostic Radiology Physician	$135.5K	$0
Zbigniew Cichon	NC	Internal Medicine Physician	$109.7K	$14K
Courtney Prim	NC	Physician Assistant	$82.9K	$0

Wilkes Pediatric Clinic, PLLC — Billing Profile & Reimbursement Data

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Wilkes Pediatric Clinic, PLLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References