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

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

Capernaum Medical Center For Kids PLLC (NPI 1881146413)

Capernaum Medical Center For Kids PLLC is a clinical neurophysiology physician provider located in Lakeland, Florida. This profile covers 0 Medicare and 24 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	Capernaum Medical Center For Kids PLLC
Address	2024 Edgewood Dr S
City	Lakeland
State	FL
ZIP	33803
Taxonomy	Clinical Neurophysiology Physician
NPI Enumerated	October 31, 2016

Payer Source	Total Paid
Medicaid	$7.3M
Medicare	$0

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

24 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…	58,080	$40	$2.6M
95816	Electroencephalogram or EEG is a diagnostic test that uses small electrodes attached to the scalp to measure the electrical activity of the brain. In this procedure the provider performs the EEG…	7,200	$150	$1.1M
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…	11,740	$80	$903.8K
99205	The provider sees a new 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 provider…	8,170	$80	$686.6K
95819	Electroencephalogram or EEG is a diagnostic test that uses small electrodes attached to the scalp to measure the electrical activity of the brain. In this procedure the provider performs the EEG…	1,700	$230	$389.3K
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…	15,600	$20	$343.2K
95956	N/A	290	$1,150	$337.8K
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…	3,830	$80	$291.4K
95720	A physician or other QHCP reviews recorded events and analyzes spike and seizure detection of a continuous electroencephalography, a study of the electrical activity of the brain. A video is…	2,080	$120	$238.7K
95700	The patient undergoes a minimum 8–channel EEG, a study of the electrical activity of the brain, administered by an EEG technologist. Video recording as well as setup and takedown and patient…	1,970	$90	$169.8K

Showing 1–10 of 24

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Florida Distribution

Capernaum Medical Center For Kids PLLC — 7 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Florida

Full comparison — all codes billed, vs. Florida median

24 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
95956	N/A	1	10	290	$1,150	$337.7K
95715	The patient undergoes electroencephalography, a study of the electrical activity of the brain, lasting 12 to 26 hours with intermittent monitoring and maintenance. A video recording is made, and an…	4	10	160	$420	$210.1K
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…	336	5,930	460	$40	$169.3K
95716	The patient undergoes electroencephalography, a study of the electrical activity of the brain, with continuous, real–time monitoring and maintenance. A video recording is made, and an EEG…	3	20	230	$560	$158.3K
95819	Electroencephalogram or EEG is a diagnostic test that uses small electrodes attached to the scalp to measure the electrical activity of the brain. In this procedure the provider performs the EEG…	10	100	110	$270	$142.4K
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…	29	6,380	430	$50	$139.3K
95720	A physician or other QHCP reviews recorded events and analyzes spike and seizure detection of a continuous electroencephalography, a study of the electrical activity of the brain. A video is…	4	40	330	$170	$128.3K
95816	Electroencephalogram or EEG is a diagnostic test that uses small electrodes attached to the scalp to measure the electrical activity of the brain. In this procedure the provider performs the EEG…	1	100	130	$210	$103K
95951	N/A	22	30	280	$290	$89.4K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	1,032	1,500	470	$30	$87.2K

Showing 1–10 of 24

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Philadelphia Professionals Inc	FL	Home Health Agency	$0	$21M
Children And Teen Dental Group Of Florida	FL	General Practice Dentistry	$0	$11.5M
Linwood Bond	FL	Dermatology Physician	$760.9K	$0
Cory Lord	FL	Nurse Practitioner	$241K	$0
Jarett Gregory	FL	Internal Medicine Physician	$219.7K	$0
Rakesh Patel	FL	Urology Physician	$176.1K	$0
Allan Wells	FL	Family Medicine Physician	$133.8K	$0
Zully Calvo	FL	Podiatrist	$127.3K	$0
Stuart Patterson	FL	Orthopaedic Hand Surgery Physician	$125.5K	$0
Finah Vida	FL	Internal Medicine Physician	$118.1K	$0

Capernaum Medical Center For Kids PLLC — Billing Profile & Reimbursement Data

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Capernaum Medical Center For Kids PLLC — 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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Frequently Asked Questions

References