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

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

Southern Indiana Pediatrics P.s.c. (NPI 1811043854)

Southern Indiana Pediatrics P.s.c. is a pediatrics physician provider located in Jeffersonville, Indiana. This profile covers 0 Medicare and 42 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	Southern Indiana Pediatrics P.s.c.
Address	1701 Spring St
City	Jeffersonville
State	IN
ZIP	47130
Taxonomy	Pediatrics Physician
NPI Enumerated	January 25, 2007

Payer Source	Total Paid
Medicaid	$2.6M
Medicare	$0

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

42 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…	11,960	$70	$872.9K
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…	11,710	$50	$620.8K
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…	2,620	$80	$196.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2,350	$70	$171.8K
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…	2,330	$70	$165.4K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	11,330	$10	$124.6K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	5,310	$20	$106.2K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	2,120	$30	$72.2K
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.	4,080	$10	$53K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	710	$70	$51.3K

Showing 1–10 of 42

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Indiana Distribution

Southern Indiana Pediatrics P.s.c. — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. Indiana median

42 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…	232	2,120	870	$60	$450.6K
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…	312	2,380	920	$50	$376.8K
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…	88	280	880	$80	$267.2K
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…	79	290	770	$80	$250.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	61	320	310	$80	$133.9K
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…	98	160	740	$60	$119.1K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	71	390	990	$20	$74.5K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	121	290	3,410	$1	$71.5K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	108	290	130	$40	$69.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	80	290	160	$80	$67.3K

Showing 1–10 of 42

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Optum Pharmacy 702, LLC	IN	Community/Retail Pharmacy	$0	$55.1M
Lifespring, Inc	IN	Community/Behavioral Health Agency	$0	$53.5M
Maxim Healthcare Services, Inc.	IN	Home Health Agency	$0	$30.1M
Lifespring, Inc	IN	Community/Behavioral Health Agency	$0	$21.6M
Norton Clark Hospital, LLC	IN	General Acute Care Hospital	$0	$19.7M
North Clark Medical Group LLC	IN	General Practice Physician	$0	$16.1M
Pediatric Plus Home Healthcare Services LLC	IN	Home Health Agency	$0	$8.3M
Pax Riverbend LLC	IN	Substance Use Disorder Rehabilitation Clinic/Center	$0	$8M
Utica Township Volunteer Fire Fighters Association	IN	Land Ambulance	$1.6M	$4.9M
Eye Associates Of Southern Indiana PC	IN	Ophthalmology Physician	$0	$6.4M

Southern Indiana Pediatrics P.s.c. — Billing Profile & Reimbursement Data

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Southern Indiana Pediatrics P.s.c. — 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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