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.

Sulphur Pediatric Clinic Medical Corporation (NPI 1821042086)

Sulphur Pediatric Clinic Medical Corporation is a pediatrics physician provider located in Sulphur, Louisiana. This profile covers 0 Medicare and 88 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	Sulphur Pediatric Clinic Medical Corporation
Address	600 Cypress Street
City	Sulphur
State	LA
ZIP	70663
Taxonomy	Pediatrics Physician
NPI Enumerated	May 20, 2006

Payer Source	Total Paid
Medicaid	$19M
Medicare	$0

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

88 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…	79,600	$60	$5M
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…	109,930	$40	$4.5M
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…	24,570	$60	$1.4M
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…	21,580	$70	$1.4M
98960	A nonphysician qualified healthcare professional uses a standard curriculum to educate a patient about their disease or disorder and how to manage it more effectively. This code represents each 30…	14,600	$70	$1M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	14,970	$70	$988K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	51,280	$10	$666.6K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	9,420	$70	$649.8K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	20,530	$30	$554.2K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	34,920	$20	$523.7K

Showing 1–10 of 88

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

Sulphur Pediatric Clinic Medical Corporation — 17 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

88 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…	25	2,890	980	$40	$246.8K
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…	114	210	630	$70	$239.6K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	38	50	210	$200	$206K
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…	32	3,230	1,120	$30	$204.3K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	40	50	400	$150	$168.8K
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…	9	360	780	$50	$141.5K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	7	170	640	$30	$138.8K
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…	9	420	740	$50	$137.3K
99204	The provider sees a new 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 provider…	798	1,170	160	$80	$102.7K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	147	260	800	$10	$96.7K

Showing 1–10 of 88

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Louisiana United Methodist Children & Family Services, Inc	LA	Psychiatric Residential Treatment Facility	$0	$23.7M
Calcasieu Cameron Hospital Service District	LA	General Acute Care Hospital	$0	$12.3M
Calcasieu Cameron Emergency Physician Group LLC	LA	Emergency Medicine Physician	$0	$4.9M
Brian Stewart	LA	Family Medicine Physician	$253.3K	$0
Jose Gonzales	LA	Family Medicine Physician	$199.5K	$0
Kevin Guilbeaux	LA	Physical Therapist	$180.4K	$0
Tyler Butler	LA	Physical Therapist	$177.4K	$0
Geoffrey Collins	LA	Orthopaedic Surgery Physician	$167.9K	$0
Preston Stelly	LA	Physical Therapist	$156.6K	$0
Maureen Lannan	LA	Family Medicine Physician	$142.2K	$0

Sulphur Pediatric Clinic Medical Corporation — Billing Profile & Reimbursement Data

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Sulphur Pediatric Clinic Medical Corporation — 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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References