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

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

Coker Pediatrics LLC (NPI 1871707489)

Key Findings

Field	Value
Entity Type	Organization
Organization	Coker Pediatrics LLC
Address	14557 Highway 19
City	Griffin
State	GA
ZIP	30224
Taxonomy	Pediatrics Physician
NPI Enumerated	May 10, 2007

Payer Source	Total Paid
Medicaid	$9.5M
Medicare	$0

This provider is effectively a Medicaid-focused pediatric practice: there is no Medicare billing on file while reported Medicaid revenue totals $9.5M, indicating a single-payer operational footprint dominated by Medicaid patients. Analysts should treat Medicaid as the primary payer when modeling revenue and utilization for this entity.

Revenue is highly concentrated in a small set of outpatient E/M and preventive codes: the top 3 Medicaid codes by revenue account for 66.8% of total Medicaid revenue, led by 99214 ($3M, 31.9%), 99213 ($2.7M, 28.2%), and 99392 ($636.8K, 6.7%). This concentration implies most Medicaid dollars flow from established patient visits and routine preventive care.

The code mix signals a high-volume ambulatory pediatrics operation: 99214 and 99213 are the largest revenue drivers and reflect frequent established patient office visits with moderate and low levels of decision making respectively, consistent with chronic care follow-up and routine sick visits. Complementary preventive codes such as 99392 and 99391 plus immunization administration (90460) further indicate a strong well-child and vaccination workload rather than specialty or inpatient services.

Preventive and immunization services are a material part of the practice’s offering: 99392 generates $636.8K (6.7%), 99391 generates $534.2K (5.6%), 99393 $476.5K (5.0%), and vaccine administration 90460 produces $635.5K (6.7%) in Medicaid revenue. These figures, together with high volumes of well-child visit codes, point to an operational emphasis on routine pediatric prevention and immunization delivery.

The practice shows above-typical statewide testing and respiratory diagnostic activity: 87428 accounts for $451K (4.8%) and ranks #5 of 60 in-state (93th percentile; notably above typical state volume for this code), while rapid antigen tests 87804 and 87880 each have 13.4K claims and rank in the high percentiles. This pattern suggests onsite or closely integrated testing throughput for acute respiratory illness in the pediatric population.

For core evaluation-and-management codes the provider is a major in-state participant: 99214 ranks #20 of 824 providers in-state (98th percentile; notably above typical state volume for this code) and 99213 ranks #27 of 917 (97th percentile; notably above typical state volume for this code). These rankings indicate the practice is among the highest-volume Medicaid billers in Georgia for established pediatric visits.

Beyond the top drivers, the provider bills a broad mix of pediatric screening and ancillary services at modest revenue levels—examples include behavioral/developmental screen 96127 (4.3K claims, $4 avg paid/claim, $17.1K revenue) and lead test 83655 (598 claims, $9 avg paid/claim, $5.4K revenue). This breadth is consistent with a full-scope pediatric clinic that offers routine developmental screening, basic lab work, and preventive counseling in addition to high-volume E/M care.

The practice has an established presence in the market with its NPI enumerated 2007-05-10 (~19 years ago), suggesting stability and a longstanding relationship with the Medicaid population in Griffin, GA. Combined with the high-volume rankings on key pediatric codes, tenure supports the view of a mature Medicaid-centric ambulatory pediatric provider rather than a recently entered or niche operation.

Medicaid: Complete Services Breakdown

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

52 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…	34,370	$90	$3M
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…	42,450	$60	$2.7M
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…	6,850	$90	$636.8K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	13,820	$50	$635.5K
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…	6,000	$90	$534.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5,070	$90	$476.5K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	7,160	$60	$451K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,750	$100	$286.3K
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,…	6,730	$40	$242.4K
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.	13,400	$10	$187.6K

Showing 1–10 of 52

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Georgia Distribution

Coker Pediatrics LLC — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. Georgia median

52 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…	27	920	370	$60	$360.6K
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…	20	820	390	$70	$245K
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…	19	180	680	$90	$226.7K
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…	20	180	720	$90	$204.2K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	21	250	660	$40	$172.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	19	170	500	$100	$170.6K
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,…	38	360	370	$50	$153.6K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	25	160	190	$110	$129.7K
99051	The provider sees a patient during regular office hours that occur outside of traditional office hours, i.e., in the evening, on a weekend, or on a holiday.	18	50	100	$20	$119.1K
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…	142	140	940	$1	$82.1K

Showing 1–10 of 52

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Georgia Emergency Group, LLC	GA	Emergency Medicine Physician	$0	$6.3M
Sunnyside Pediatrics	GA	Pediatrics Physician	$0	$5.4M
Leiv Takle	GA	Ophthalmology Physician	$328.3K	$0
Georgia Hospitalists Group, LLC	GA	Hospitalist Physician	$0	$299.1K
Aaron Roquemore	GA	Professional Counselor	$0	$291K
Grace Medical Clinic	GA	Internal Medicine Physician	$0	$275.4K
Hari Madichetty	GA	Specialist	$187.3K	$0
Mark Henson	GA	Foot & Ankle Surgery Podiatrist	$148.5K	$0
Joan Johnson	GA	Gerontology Nurse Practitioner	$112.7K	$0
John Dupre	GA	Pulmonary Disease Physician	$107K	$0

Coker Pediatrics LLC — Billing Profile & Reimbursement Data

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Coker Pediatrics 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