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.

Purohit Pediatric Clinic, LLC (NPI 1790971166)

Key Findings

Field	Value
Entity Type	Organization
Organization	Purohit Pediatric Clinic, LLC
Address	516 Quintard Ave
City	Anniston
State	AL
ZIP	36201
Taxonomy	Specialist
NPI Enumerated	September 19, 2007

Payer Source	Total Paid
Medicaid	$23.2M
Medicare	$0

PUROHIT PEDIATRIC CLINIC, LLC is effectively a Medicaid-focused practice: lifetime Medicare revenue is none (no Medicare billing on file) while lifetime Medicaid revenue is $23.2M, indicating the clinic’s revenue footprint is concentrated in Medicaid payor activity and not diversified across Medicare. The practice’s NPI was enumerated 2007-09-19 (~19 years ago), indicating long-standing enrollment and operational history in the Medicaid market.

Revenue is highly concentrated in a small set of Medicaid codes: the precomputed top 3 Medicaid codes account for 60.3% of this provider’s total Medicaid revenue. Those top drivers are 99214 ($8.2M revenue, 38.5% of Medicaid revenue), 99213 ($2.9M revenue, 13.8% of Medicaid revenue), and 87633 ($1.7M revenue, 8.0% of Medicaid revenue), showing most Medicaid dollars originate from established patient E/M visits plus high-volume respiratory nucleic acid testing.

The code mix shows this clinic operates as a high-volume pediatric outpatient and preventive-care center: 99214 (92.6K claims, $89 avg paid/claim, $8.2M) and 99213 (49.9K claims, $59 avg paid/claim, $2.9M) dominate, and a suite of well-child preventive codes (99392, 99391, 99393, 99394) together contribute materially to revenue. This pattern is consistent with a throughput model focused on frequent established visits and routine preventive visits for children and adolescents.

Testing and infectious-disease screening are a distinct secondary service line: respiratory and viral testing codes appear repeatedly in the top list, including 87633 (9.5K claims, $180 avg paid/claim, $1.7M), 87635 (18.1K claims, $41 avg paid/claim, $741.8K), 87811 (16.3K claims, $24 avg paid/claim, $391.2K), 87636 (4.2K claims, $92 avg paid/claim, $389.9K), and 87634 (9.5K claims, $44 avg paid/claim, $417.5K). These volumes indicate substantial in-clinic or lab-based respiratory testing capacity that complements the office visit workload.

Immunizations and newborn services are also meaningful revenue contributors, signaling robust pediatric preventive care throughput: examples include 90670 (11.3K claims, $24 avg paid/claim, $271.5K), 90648 (14.6K claims, $18 avg paid/claim, $262K), 90723 (10.8K claims, $19 avg paid/claim, $204.8K), 90633 (6.2K claims, $19 avg paid/claim, $118.2K) and newborn evaluation 99460 (3.2K claims, $76 avg paid/claim, $243K). Several vaccine and newborn codes rank at very high percentiles in-state, supporting the profile of an active pediatric immunization and newborn follow-up practice.

Competitive standing within Alabama is strong on core pediatric ambulatory codes: 99214 ranks #8 of 1990 providers in-state (100th percentile; extreme outlier) and 99213 ranks #25 of 1988 providers in-state (99th percentile; extreme outlier), while preventive codes like 99392 and 99391 rank #5 of 299 (99th percentile; extreme outlier) and #6 of 270 (98th percentile; extreme outlier), respectively. These ranks and percentile labels indicate the clinic is a dominant statewide provider for established E/M and well-child services, operating at volumes far above typical peers.

Statistical labels in the top codes reinforce where the practice is an outlier versus typical: multiple high-volume codes are explicitly flagged as "extreme outlier" or "notably above typical state volume" (for example 99214, 99213, 99392, 99391, 90648, 90723 and several vaccine codes). Other testing codes are characterized as "typical, unremarkable volume" (for example 87633, 87636, 87634), indicating that while testing is sizable, only the E/M and preventive visit lines truly distinguish this clinic from peers.

Operationally, the combination of very high claim counts for E/M codes (e.g., 92.6K claims for 99214 and 49.9K claims for 99213) plus large vaccine and testing volumes suggests a high-throughput pediatric practice with integrated point-of-care testing and immunization workflows. Given the absence of Medicare billing and the heavy Medicaid concentration, payer negotiation leverage and revenue risk are concentrated on Medicaid policy and reimbursement changes rather than on cross-payer diversification.

Medicaid: Complete Services Breakdown

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

95 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	92,580	$90	$8.2M
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…	49,870	$60	$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…	9,520	$180	$1.7M
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…	17,490	$60	$1.1M
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…	16,940	$60	$1.1M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	13,280	$60	$783.3K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	18,090	$40	$741.8K
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.	27,510	$20	$550.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	7,830	$60	$469.7K
87634	The lab analyst performs a test for respiratory syncytial virus (RSV) antigen detection using amplified nucleic acid probe technique.	9,490	$40	$417.5K

Showing 1–10 of 95

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

Purohit Pediatric Clinic, LLC — 18 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

95 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	9	100	470	$130	$1.2M
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	41	90	500	$40	$303.6K
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…	8	1,990	680	$60	$201.7K
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…	141	330	140	$240	$197.4K
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…	25	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…	6	270	1,360	$60	$159.7K
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…	4	50	380	$90	$157.3K
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…	5	300	1,160	$50	$147.8K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	11	110	610	$40	$143.9K
87634	The lab analyst performs a test for respiratory syncytial virus (RSV) antigen detection using amplified nucleic acid probe technique.	6	60	350	$30	$136.6K

Showing 1–10 of 95

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southern Immediate Care, LLC	AL	Urgent Care Clinic/Center	$0	$12.5M
Advantage Dental Oral Health And Vision Center Of Alabama, P.C.	AL	Pediatric Dentistry	$0	$4.6M
Anniston Emerg Med Svcs	AL	Ambulance	$1.1M	$1.9M
Calhoun County Health Dept Fp Clinic	AL	Public Health or Welfare Agency	$0	$2.2M
Mahomed Salame	AL	Cardiovascular Disease Physician	$1M	$0
Advantage Dental Oral Health And Vision Center Of Alabama, P.C.	AL	Optometrist	$0	$914.4K
Vishwanath Reddy	AL	Internal Medicine Physician	$228.5K	$0
Rodney Snead	AL	Emergency Medical Services (Emergency Medicine) Physician	$213.9K	$0
Pratibha Vashista	AL	Family Medicine Physician	$124.5K	$0
Hugh Maddox	AL	Pain Medicine (Anesthesiology) Physician	$106.3K	$0

Purohit Pediatric Clinic, LLC — Billing Profile & Reimbursement Data

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Purohit Pediatric Clinic, LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References