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.

Covenant Care Pediatrics PC (NPI 1902941503)

Covenant Care Pediatrics PC is a pediatrics physician provider located in Stockbridge, Georgia. This profile covers 0 Medicare and 48 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	Covenant Care Pediatrics PC
Address	245 Country Club Dr Bldg 200a
City	Stockbridge
State	GA
ZIP	30281
Taxonomy	Pediatrics Physician
NPI Enumerated	February 21, 2007

Payer Source	Total Paid
Medicaid	$3M
Medicare	$0

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

48 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	6,900	$90	$634.7K
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.	10,290	$60	$597.1K
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…	7,190	$70	$474.4K
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…	5,010	$90	$456K
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…	4,790	$90	$449.9K
99463	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center, through the time of discharge, or release, from the…	1,700	$100	$175.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	720	$90	$65K
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,…	1,200	$40	$44.2K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	3,890	$10	$38.9K
99429	Use 99429 to report a preventive medicine service that does not have a specific code.	1,840	$10	$20.3K

Showing 1–10 of 48

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

Covenant Care Pediatrics PC — 1 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

48 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…	133	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…	119	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…	30	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…	14	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.	31	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.	74	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,…	105	360	370	$50	$153.6K
99203	The provider sees a new 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 provider…	159	310	90	$90	$136.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	102	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.	28	50	100	$20	$119.1K

Showing 1–10 of 48

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Apex Family Healthcare Services, LLC	GA	Community/Behavioral Health Agency	$0	$19M
Pacific Health Systems LLC	GA	Home Health Agency	$0	$9.9M
Southern Crescent Pediatrics PC	GA	Pediatrics Physician	$0	$9.6M
Healthsource Agency Inc	GA	Home Health Agency	$0	$5.8M
Piedmont Hospitalist Physicians LLC	GA	Family Medicine Physician	$0	$3.6M
National Premier Laboratories Inc	GA	Clinical Medical Laboratory	$0	$3.4M
Stockbridge Pediatrics	GA	Pediatrics Physician	$0	$2.6M
Surgical Center For Urology LLC	GA	Ambulatory Surgical Clinic/Center	$805.2K	$0
Regenerative Orthopaedics Surgery Center, LLC	GA	Ambulatory Surgical Clinic/Center	$622K	$0
Tambrea Ellison	GA	Physical Medicine & Rehabilitation Physician	$509.4K	$0

Covenant Care Pediatrics PC — Billing Profile & Reimbursement Data

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Covenant Care Pediatrics PC — 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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