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

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

Selma Peditrics, P.C. (NPI 1922291996)

Key Findings

Field	Value
Entity Type	Organization
Organization	Selma Peditrics, P.C.
Address	1225 Medical Center Pkwy
City	Selma
State	AL
ZIP	36701
Taxonomy	Pediatrics Physician
NPI Enumerated	August 23, 2007

Payer Source	Total Paid
Medicaid	$21M
Medicare	$0

SELMA PEDITRICS, P.C. appears to be essentially a Medicaid-focused pediatric practice: it has no Medicare billing on file and $21M in lifetime Medicaid revenue, indicating the provider’s commercial/Medicare exposure is minimal to nonexistent while Medicaid accounts for its entire documented revenue footprint. This makes the entity effectively single-payer (Medicaid) in the available claims data and suggests operations and payer relationships are structured around pediatric state programs.

Revenue concentration is very high: the precomputed top 3 Medicaid codes account for 74.0% of the provider’s total Medicaid revenue, showing the practice derives the bulk of its income from a very limited set of services. The top single code, 99214, alone represents $12.2M (61.5% of Medicaid revenue), which underscores dependence on higher-level established pediatric office visits for revenue.

The code mix and highest-volume codes indicate a preventive and primary care–oriented pediatric operation. High volumes for 99214, 99213, and well-child preventive codes (99392, 99391, 99393, 99394) imply routine management of established patients and frequent well visits, with immunizations and vaccine administration (e.g., 90633, 90698, 90651, 90686, 90680) also prominent. This pattern is consistent with a clinic that provides longitudinal primary pediatric care and vaccination services.

SELMA PEDITRICS is a strong competitive player in-state on multiple pediatric service lines: 99214 ranks #4 of 1990 providers in-state and is described as an "extreme outlier, far above typical state volume for this code," while other primary E/M and preventive codes (99213 at the 96th percentile; 99392/99391/99393/99394 at the 96–99th percentiles) are also well above typical state volumes. These ranks indicate the practice is a major in-state provider for established pediatric visits and preventive services, far exceeding the activity of most peers.

The practice also shows outsized activity in certain diagnostic and screening services. High ranks and percentiles for testing and specimen collection codes (e.g., 87428 at the 99th percentile and G2023 at the 97th percentile) and point-of-care tests (87880, 87804) indicate substantial in-office respiratory and infectious disease testing volume during the sample period. This suggests the clinic handles acute respiratory evaluation and testing in addition to routine pediatrics.

Several vaccine codes and preventive interventions appear as notable outliers in state volume: 90633 ranks #4 of 233 providers (99th percentile), 90651 ranks #5 of 209 providers (98th percentile), and 90670/90698/90686/90680 also rank above typical volumes. The concentration of vaccine administration codes alongside the heavy E/M volumes reinforces that immunizations and well-child care are core service lines driving Medicaid revenue.

The practice’s NPI has been enumerated since 2007-08-23 (~19 years ago), indicating a long tenure in the market, which may help explain high patient volume and established referral or enrollment patterns with Medicaid in the region. Longevity combined with the concentrated code mix is consistent with a stable, established pediatric clinic serving a large Medicaid population.

While many codes are extreme or notable outliers in state rank, some ancillary services generate more typical volumes (e.g., 87633 at the 59th percentile, several lab/molecular COVID codes in the mid-80s percentile, and common lab tests like 85025 at the 85th percentile). This mix shows dominance in core pediatric visits and vaccinations while maintaining expected participation in routine lab and molecular testing services.

Medicaid: Complete Services Breakdown

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

86 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…	125,360	$100	$12.2M
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…	28,200	$60	$1.6M
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…	13,020	$60	$833.3K
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…	10,990	$70	$714.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	10,930	$60	$677.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	9,460	$60	$586.3K
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…	9,350	$50	$467.6K
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…	2,540	$140	$355K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	2,380	$90	$216.3K
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.	15,170	$10	$197.2K

Showing 1–10 of 86

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alabama Distribution

Selma Peditrics, P.C. — 18 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. Alabama median

86 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	41	100	470	$130	$1.2M
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	1,990	680	$60	$201.7K
86235	The lab analyst performs an assay to evaluate the patient’s serum for each antibody to an extractable nuclear antigen, also called ENA. Types of ENA antibodies include anti ribonuclear protein,…	2	10	190	$50	$194.3K
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…	74	1,990	560	$40	$185.6K
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.	43	100	480	$20	$165.1K
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…	13	270	1,360	$60	$159.7K
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…	11	300	1,160	$50	$147.8K
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…	84	110	610	$40	$143.9K
87634	The lab analyst performs a test for respiratory syncytial virus (RSV) antigen detection using amplified nucleic acid probe technique.	28	60	350	$30	$136.6K
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…	75	250	420	$50	$133K

Showing 1–10 of 86

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Dentistry Of Central Alabama, PC	AL	Pediatric Dentistry	$0	$27.3M
Vaughan Regional Medical Center LLC	AL	Rural Acute Care Hospital	$0	$8.1M
Dallas County Health Dept Fp Clinic	AL	Public Health or Welfare Agency	$0	$2.5M
University Of Alabama At Birmingham	AL	Family Medicine Physician	$0	$2.2M
Song Eye Center	AL	Ophthalmic Technician/Technologist	$0	$1.7M
Rural Health Medical Program, Inc.	AL	Federally Qualified Health Center (FQHC)	$0	$1.6M
Selma Family Practice Optometry, Inc.	AL	Optometrist	$0	$1.2M
Bio-medical Applications Of Alabama, Inc.	AL	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1M
Bio-medical Applications Of Alabama, Inc.	AL	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$931.6K
Behavioral Health Of Selma, LLC	AL	Psychologist	$0	$930.6K

Selma Peditrics, P.C. — Billing Profile & Reimbursement Data

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Selma Peditrics, P.C. — 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