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

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

Gulf Coast Children's Clinic, PA (NPI 1750571170)

Gulf Coast Children's Clinic, PA is a clinic/center provider located in Ocean Springs, Mississippi. This profile covers 0 Medicare and 62 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	Gulf Coast Children's Clinic, PA
Address	3650 Groveland Rd
City	Ocean Springs
State	MS
ZIP	39564
Taxonomy	Clinic/Center
NPI Enumerated	August 1, 2007

Payer Source	Total Paid
Medicaid	$11.2M
Medicare	$0

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

62 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…	95,950	$50	$5.2M
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…	20,200	$70	$1.5M
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…	12,040	$80	$939.4K
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…	11,300	$80	$937.8K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	20,260	$20	$405.2K
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,…	11,600	$30	$394.3K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	29,870	$10	$328.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	3,600	$80	$281K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	22,800	$10	$228K
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.	20,580	$10	$226.3K

Showing 1–10 of 62

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Mississippi Distribution

Gulf Coast Children's Clinic, PA — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Mississippi

Full comparison — all codes billed, vs. Mississippi median

62 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	6	1,910	930	$60	$278.7K
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…	13	170	1,210	$90	$275K
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…	12	220	470	$90	$212.2K
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…	47	1,670	720	$50	$196.4K
94640	The provider administers oxygen under pressure or not under pressure to open obstructed air passages. He uses any of the listed devices to treat a patient with an acute obstruction of the airway that…	70	140	400	$80	$191K
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,…	17	670	230	$60	$89.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	11	230	190	$80	$74.6K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	23	60	450	$70	$73.7K
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…	85	270	130	$60	$57.4K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	594	750	400	$20	$52.5K

Showing 1–10 of 62

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Certus Laboratories, LLC	MS	Clinical Medical Laboratory	$1.4M	$2M
Mississippi Coast Ob/gyn, P.A.	MS	Obstetrics & Gynecology Physician	$0	$2M
Jason Rector	MS	Pediatric Dentistry	$0	$1.8M
Dva Healthcare Renal Care Inc	MS	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.6M
Ocean Springs Surgical And Endoscopy Center LLC	MS	Ambulatory Surgical Clinic/Center	$763.4K	$132.9K
Michele Hughes	MS	Dermatology Physician	$713.5K	$320
Rishi Roy	MS	Vascular Surgery Physician	$671K	$0
James Sutton	MS	Ophthalmology Physician	$374.1K	$233.4K
Edward Aldridge	MS	General Practice Physician	$86.7K	$342.4K
Mississippi Eye Surgery Center	MS	Ambulatory Surgical Clinic/Center	$329.4K	$16.9K

Gulf Coast Children's Clinic, PA — Billing Profile & Reimbursement Data

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Gulf Coast Children's Clinic, PA — 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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