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

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

Hometown Pediatrics LLC (NPI 1669091120)

Hometown Pediatrics LLC is a pediatrics physician provider located in Athens, Alabama. This profile covers 0 Medicare and 39 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	Hometown Pediatrics LLC
Address	22136 Medical Village Drive
City	Athens
State	AL
ZIP	35613
Taxonomy	Pediatrics Physician
NPI Enumerated	April 14, 2020

Payer Source	Total Paid
Medicaid	$4.3M
Medicare	$0

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

39 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	22,050	$180	$4M
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	390	$210	$81.1K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	740	$60	$42.9K
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	1,460	$20	$23.4K
90700	This code represents a DTaP vaccine product administered into the muscle to protect against diphtheria, tetanus, and pertussis (whooping cough). It is used for children younger than 7 years of age.	2,330	$10	$18.7K
90648	This code represents a Haemophilus influenzae type b (Hib) vaccine product administered into the muscle to protect against Hib disease. This formulation uses a PRP–T conjugate and follows a four–dose…	1,940	$10	$13.6K
90713	This code represents an IPV vaccine product administered beneath the skin or into the muscle to protect against poliomyelitis (polio). This is an inactivated, or killed, virus vaccine.	1,610	$10	$12.8K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	430	$30	$11.5K
90671	This code represents a vaccine product administered intramuscularly to protect against pneumococcal disease, a bacterial infection. This is a 15–valent vaccine, protecting against 15 strains of the…	570	$20	$10.8K
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.	870	$10	$10.4K

Showing 1–10 of 39

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alabama Distribution

Hometown Pediatrics LLC — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. Alabama median

39 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	65	240	6,820	$120	$2.9M
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	54	100	470	$130	$1.2M
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…	571	1,990	680	$60	$201.7K
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…	230	1,990	560	$40	$185.6K
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…	103	270	1,360	$60	$159.7K
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…	128	300	1,160	$50	$147.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	174	320	640	$50	$98.1K
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…	162	200	170	$50	$60.5K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	90	230	410	$40	$59.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	233	300	330	$50	$56.3K

Showing 1–10 of 39

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lindsey Rodriguez Dmd, LLC	AL	Pediatric Dentistry	$0	$1.1M
John Boyett	AL	Orthopaedic Surgery Physician	$303.8K	$0
Stevon Boyett	AL	Physical Medicine & Rehabilitation Physician	$274.1K	$0
Diagnostic Health Mri Of Gadsden, LLC	AL	Radiology Clinic/Center	$205.4K	$0
Joseph Boyett	AL	Sports Medicine (Orthopaedic Surgery) Physician	$196K	$0
Eric Hatfield	AL	Sports Medicine (Family Medicine) Physician	$152.6K	$0
James Stanford	AL	Sports Medicine (Orthopaedic Surgery) Physician	$144.2K	$0
William Lawrence	AL	Orthopaedic Surgery Physician	$135.3K	$0
Shearon Craig	AL	Physical Therapist	$89.7K	$0
Paul Papajohn	AL	Specialist	$75.1K	$0

Hometown Pediatrics LLC — Billing Profile & Reimbursement Data

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Hometown 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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