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

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

Pediatric Cardiology Of Southwest Louisiana, LLC (NPI 1962559740)

Pediatric Cardiology Of Southwest Louisiana, LLC is a pediatric cardiology physician provider located in Lake Charles, Louisiana. This profile covers 0 Medicare and 15 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	Pediatric Cardiology Of Southwest Louisiana, LLC
Address	2005 Southwood Dr
City	Lake Charles
State	LA
ZIP	70605
Taxonomy	Pediatric Cardiology Physician
NPI Enumerated	January 4, 2007

Payer Source	Total Paid
Medicaid	$6.1M
Medicare	$0

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	19,470	$140	$2.8M
93320	The provider performs a complete Doppler echocardiography, which uses high–frequency sound waves to create a two–dimensional image of the heart, while the use of Doppler technology allows…	19,360	$50	$987.1K
93325	The provider performs Doppler echocardiography, a diagnostic procedure based on the Doppler effect of sound, color flow velocity mapping, a two–dimensional image representation of blood flow in the…	19,780	$30	$672.4K
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…	8,060	$60	$499.5K
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…	4,200	$90	$365K
93224	In this procedure, the provider applies an electrocardiographic, or ECG recorder, to a patient for up to 48 hours to detect abnormal heart rates and rhythms. He analyzes, compiles, and interprets the…	3,400	$80	$255.2K
93000	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	18,130	$10	$235.6K
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…	1,720	$80	$134.2K
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…	2,570	$40	$105.2K
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…	750	$60	$47.1K

Showing 1–10 of 15

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Louisiana Distribution

Pediatric Cardiology Of Southwest Louisiana, LLC — 4 of 15 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Louisiana

Full comparison — all codes billed, vs. Louisiana median

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	1	30	2,260	$110	$460.1K
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…	425	2,890	980	$40	$246.8K
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…	1,157	3,230	1,120	$30	$204.3K
93325	The provider performs Doppler echocardiography, a diagnostic procedure based on the Doppler effect of sound, color flow velocity mapping, a two–dimensional image representation of blood flow in the…	3	30	1,290	$30	$172.6K
93320	The provider performs a complete Doppler echocardiography, which uses high–frequency sound waves to create a two–dimensional image of the heart, while the use of Doppler technology allows…	1	30	1,820	$40	$163.1K
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…	70	1,170	160	$80	$102.7K
93268	In this service, the provider uses electrocardiographic leads and a monitor to assess the occurrence of cardiac events in a patient, even when the patient is at home. He records the data throughout…	3	10	170	$130	$85.4K
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…	88	700	180	$60	$77K
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…	332	1,280	180	$50	$64.8K
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,…	457	1,460	440	$20	$64K

Showing 1–10 of 15

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Calcasieu Urgent Care LLC	LA	Urgent Care Clinic/Center	$0	$39.5M
Resource Management Services, Inc. Of Southwest Louisiana	LA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$20.7M
Southwest Louisiana Independence Center, Inc	LA	In Home Supportive Care Agency	$0	$14.4M
Christus Health Southwestern Louisiana	LA	General Acute Care Hospital	$0	$11.8M
Medical Resources & Guidance, Inc.	LA	Case Management Agency	$0	$10.3M
Direct Care, Inc.	LA	Developmentally Disabled Services Day Training Agency	$0	$10.1M
Calcasieu Emergency Group LLC	LA	Emergency Medicine Physician	$0	$7.4M
Vcphcs Vi, LLC	LA	Substance Use Disorder Rehabilitation Clinic/Center	$110.8K	$6.7M
1st Abundant Home Care, LLC	LA	Developmentally Disabled Services Day Training Agency	$0	$5.1M
Regional Healthcare-lake Charles, LLC	LA	In Home Supportive Care Agency	$0	$5M

Pediatric Cardiology Of Southwest Louisiana, LLC — Billing Profile & Reimbursement Data

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Pediatric Cardiology Of Southwest Louisiana, LLC — 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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