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.

Bayou Pediatric Associates, Apmc (NPI 1710061627)

Bayou Pediatric Associates, Apmc is a pediatrics physician provider located in Houma, Louisiana. 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	Bayou Pediatric Associates, Apmc
Address	8120 Main St
City	Houma
State	LA
ZIP	70360
Taxonomy	Pediatrics Physician
NPI Enumerated	October 25, 2006

Payer Source	Total Paid
Medicaid	$7.9M
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…	44,410	$50	$2.1M
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…	17,710	$70	$1.2M
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…	11,440	$70	$789.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	10,820	$70	$746.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	8,430	$80	$640.4K
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,…	22,760	$30	$569K
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…	7,590	$60	$462.7K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	23,040	$10	$322.5K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	14,610	$10	$204.5K
92551	The provider delivers a limited series of tones or sounds to a patient to determine if the patient’s hearing is in an acceptable range to detect hearing problems.	23,060	$10	$184.5K

Showing 1–10 of 63

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

Bayou Pediatric Associates, Apmc — 9 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

63 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…	181	2,890	980	$40	$246.8K
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…	116	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…	26	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…	20	420	740	$50	$137.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	16	490	310	$50	$84.7K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	665	700	180	$60	$77K
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,…	36	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.	15	490	170	$50	$62K
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,…	42	390	380	$20	$50.7K
17250	The provider cauterizes granulation tissue using chemicals like silver nitrate or potassium hydroxide to heal the injured tissue.	14	30	50	$30	$42.4K

Showing 1–10 of 63

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Physicians Group Laboratories, LLC	LA	Clinical Medical Laboratory	$886.8K	$208.1M
Start Corporation	LA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$45.3M
Cardiovascular Institute Of The South, LLC	LA	Cardiovascular Disease Physician	$0	$32.6M
Ascent Health, Inc	LA	Community/Behavioral Health Agency	$0	$16.3M
Terrebonne Parish Hospital Service District #1	LA	General Acute Care Hospital	$0	$16.1M
Start Corporation	LA	Federally Qualified Health Center (FQHC)	$0	$15.6M
Gulf Coast Teaching Family Services, Inc.	LA	Community/Behavioral Health Agency	$0	$13M
Teche Action Board, Inc.	LA	Federally Qualified Health Center (FQHC)	$0	$11M
1st A Southeast Incs, LLC	LA	Point of Service	$0	$9.3M
Claudia Cavallino Dds, LLC	LA	Pediatric Dentistry	$0	$7.4M

Bayou Pediatric Associates, Apmc — Billing Profile & Reimbursement Data

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Bayou Pediatric Associates, 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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