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

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

Lighthouse Pediatrics (NPI 1932315215)

Lighthouse Pediatrics is a pediatrics physician provider located in Biloxi, Mississippi. This profile covers 0 Medicare and 21 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	Lighthouse Pediatrics
Address	925 Tommy Munro Dr
City	Biloxi
State	MS
ZIP	39532
Taxonomy	Pediatrics Physician
NPI Enumerated	May 15, 2007

Payer Source	Total Paid
Medicaid	$1.6M
Medicare	$0

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

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	18,230	$60	$1.1M
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…	1,860	$90	$160.1K
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.	4,010	$30	$128.2K
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…	1,400	$90	$125.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	330	$90	$27.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	250	$100	$24.4K
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.	640	$20	$14K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	40	$50	$2.3K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	20	$70	$1.1K
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.	30	$10	$330

Showing 1–10 of 21

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Mississippi Distribution

Lighthouse Pediatrics — 0 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Mississippi

Full comparison — all codes billed, vs. Mississippi median

21 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…	127	1,910	930	$60	$278.7K
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…	75	170	1,210	$90	$275K
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…	87	220	470	$90	$212.2K
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.	47	160	710	$30	$119.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	90	230	190	$80	$74.6K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	58	60	450	$70	$73.7K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	88	230	140	$90	$45.5K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	121	160	300	$40	$41.8K
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.	295	620	570	$10	$38K
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.	516	580	410	$10	$22.5K

Showing 1–10 of 21

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nursing Management, Inc.	MS	Nursing Care Agency	$0	$42.3M
Gulf Coast Abc Pediatrics, Inc.	MS	Pediatrics Physician	$0	$2.1M
Avit Gremillion	MS	Ophthalmology Physician	$1.8M	$0
Golden Oak Senior Services LLC Dba Lemoyne Place	MS	Assisted Living Facility	$0	$1.5M
Antoine Rizk	MS	Cardiovascular Disease Physician	$509.1K	$0
Cedar Lake Open Mri LLC	MS	Diagnostic Radiology Physician	$276.3K	$181.6K
Paul Mullen	MS	Cardiovascular Disease Physician	$394.4K	$0
Michael Cunningham	MS	Interventional Cardiology Physician	$348.9K	$0
Rainna Bahadur	MS	Ophthalmology Physician	$288.7K	$0
Eva Magiros	MS	Cardiovascular Disease Physician	$287.2K	$0

Lighthouse Pediatrics — Billing Profile & Reimbursement Data

Sign up for Lighthouse Pediatrics — Billing Profile & Reimbursement Data policy alerts

Lighthouse Pediatrics — Billing Profile & Reimbursement Data

Sign up for Lighthouse Pediatrics — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References