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

Why is the Medicaid comparison limited to Louisiana 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. Louisiana (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 Clinic Of St Mary Parish Apmc (NPI 1679569560)

Pediatric Clinic Of St Mary Parish Apmc is a pediatrics physician provider located in Morgan City, Louisiana. This profile covers 0 Medicare and 68 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	Pediatric Clinic Of St Mary Parish Apmc
Address	1055 David Dr
City	Morgan City
State	LA
ZIP	70380
Taxonomy	Pediatrics Physician
NPI Enumerated	September 26, 2005

Payer Source	Total Paid
Medicaid	$8.8M
Medicare	$0

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

68 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…	89,230	$40	$3.7M
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…	10,890	$70	$708.1K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	8,510	$80	$672.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	8,770	$70	$570.1K
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…	9,700	$60	$553K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	7,530	$70	$519.6K
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…	7,990	$60	$487.6K
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,…	16,630	$20	$399K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	24,300	$10	$340.2K
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.	35,140	$10	$281.1K

Showing 1–10 of 68

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Louisiana Distribution

Pediatric Clinic Of St Mary Parish Apmc — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Louisiana

Full comparison — all codes billed, vs. Louisiana median

68 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…	430	2,890	980	$40	$246.8K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	3	60	250	$80	$220.7K
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…	40	3,230	1,120	$30	$204.3K
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…	20	360	780	$50	$141.5K
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…	22	420	740	$50	$137.3K
99499	Use 99499 to report evaluation and management services for which there is no specific code available.	59	60	160	$120	$99.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	21	490	310	$50	$84.7K
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…	430	1,280	180	$50	$64.8K
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,…	53	1,460	440	$20	$64K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	18	490	170	$50	$62K

Showing 1–10 of 68

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ochsner Morgan City LLC	LA	General Acute Care Hospital	$0	$10.3M
Bayou Health Elderly & Disabled Care, Inc.	LA	Personal Care Attendant	$0	$7.7M
St Mary Emergency Group LLC	LA	Emergency Medicine Physician	$0	$6.5M
St. Mary Parish Government/fairview Treatment Cente	LA	Substance Abuse Rehabilitation Facility	$0	$6M
Bayou Health Elderly & Disabled Care, Inc.	LA	Personal Care Attendant	$0	$5.6M
Odyssey House Louisiana Inc	LA	Substance Abuse Rehabilitation Facility	$0	$4.9M
Natchez Morice	LA	Obstetrics & Gynecology Physician	$1.9K	$4.6M
Darrell Solet	LA	Cardiovascular Disease Physician	$312.3K	$0
Jared Thurston	LA	Ophthalmology Physician	$216.7K	$5.5K
Francis Metz	LA	Internal Medicine Physician	$214K	$0

Pediatric Clinic Of St Mary Parish Apmc — Billing Profile & Reimbursement Data

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Pediatric Clinic Of St Mary Parish Apmc — 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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