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.

Pediatrix Medical Group Of Georgia, P.C. (NPI 1972695260)

Field	Value
Entity Type	Organization
Organization	Pediatrix Medical Group Of Georgia, P.C.
Address	1301 Concord Ter
City	Sunrise
State	FL
ZIP	33323
Taxonomy	Maternal & Fetal Medicine Physician
NPI Enumerated	September 28, 2006

Payer Source	Total Paid
Medicaid	$50.6M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and reports $50.6M in lifetime Medicaid revenue, making its commercial/payer exposure effectively concentrated in Medicaid rather than split across Medicare and Medicaid. Analysts should treat PEDIATRIX MEDICAL GROUP OF GEORGIA, P.C. as functionally a Medicaid-revenue operation for historical billing analysis and benchmarking.

Revenue is concentrated: the top three Medicaid codes (99469, 99479, 76819) together account for 38.4% of the provider’s total Medicaid revenue. Those codes individually are 99469 ($8.2M, 16.5% of Medicaid revenue), 99479 ($6.4M, 13.0%), and 76819 ($4.4M, 8.9%), indicating a small set of services drives a large share of payments.

The code mix aligns with a maternal–fetal medicine and neonatal service footprint: high-revenue neonatal/newborn care codes (99469, 99479, 99472, 99460, 99468) combined with a strong ultrasound portfolio (76819, 76811, 76816, 76820, 76817) point to an operation centered on prenatal imaging, perinatal risk management, and inpatient neonatal follow-up. This pattern suggests the group provides both high-volume fetal surveillance and substantive NICU/newborn evaluation services rather than a pure outpatient primary-care mix.

Competitive standing in-state is strong on imaging and newborn screening: 76819 ranks #1 of 233 providers in-state (100th percentile; extreme outlier, far above typical state volume) and 92650 ranks #1 of 85 providers in-state (100th percentile; extreme outlier). Multiple additional ultrasound codes (76816 rank #2 of 304, 100th percentile; 76811 rank #2 of 135, 99th percentile; 76820 rank #2 of 83, 99th percentile) also show extreme outlier volumes, indicating the provider is a dominant regional source for fetal imaging and related services.

For neonatal and low-birth-weight care the provider shows very high throughput: 99479 has 57K claims generating $6.4M (13.0% of Medicaid revenue) and ranks #3 of 45 providers in-state (95th percentile; notably above typical state volume), while 99469 has 22.4K claims producing $8.2M (16.5%) and ranks #4 of 33 (91th percentile; typical, unremarkable volume). These volumes indicate substantial case flow for both directed care of recovering low birth weight infants and subsequent management in neonatal critical care settings.

Operationally, the provider’s mix includes both acute/inpatient newborn work and outpatient evaluation: codes tied to inpatient discharge and follow-up (99238, 99472) appear alongside office E/M codes (99213, 99214) and consult codes (99243/99244), showing revenue is not limited to imaging and screenings but spans postnatal inpatient management and outpatient follow-up. This breadth implies integration across hospital-based newborn care and ambulatory maternal–fetal services.

The provider’s longevity (NPI enumerated 2006-09-28, ~20 years) combined with repeated extreme outlier rankings on several high-volume codes suggests a sustained, established market presence rather than a short-term spike in activity. Given the absence of Medicare activity, the historical revenue base and competitive position should be interpreted in the context of continued Medicaid demand and policy exposure.

Although the top three codes account for 38.4% of Medicaid revenue, roughly 61.6% of $50.6M is paid across many other procedure and E/M codes (for example, 99238 $2.3M, 99213 $2.1M, 92650 $3.1M), indicating that while a few services drive a large share of revenue, the practice also maintains diversified billing across screening, imaging, inpatient discharge management, and routine outpatient visits.

Medicaid: Complete Services Breakdown

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

104 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	22,350	$370	$8.2M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	57,010	$110	$6.4M
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	56,170	$80	$4.4M
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	17,040	$190	$3.3M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	9,770	$330	$3.2M
92650	In this procedure, the provider measures the patient’s response to sound stimuli to screen auditory potential (electrical response). The screening uses frequency nonspecific stimuli and automated…	62,730	$50	$3.1M
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	50,850	$60	$2.9M
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	32,410	$80	$2.6M
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…	36,520	$60	$2.3M
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	20,800	$110	$2.2M

Showing 1–10 of 104

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

Pediatrix Medical Group Of Georgia, P.C. — 12 of 25 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

104 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	4	30	2,120	$320	$2.3M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	5	30	2,220	$350	$1.3M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	3	50	570	$100	$1.1M
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	6	40	830	$100	$785.9K
92586	N/A	4	50	270	$40	$293.9K
99468	The provider evaluates and manages the initial care of a newborn or infant less than 28 days of age in a neonatal critical care setting.	2	20	40	$800	$292.5K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	302	320	750	$40	$232.7K
99241	Office consultation for a new or established patient, which requires these three key components: a problem focused history; a problem focused examination; and straightforward medical decision making.…	2	10	70	$150	$221.4K
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…	454	1,130	780	$90	$210.4K
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…	432	1,050	640	$80	$183.6K

Showing 1–10 of 104

Related Providers

Other providers that share a Tax Identification Number (TIN) with Pediatrix Medical Group Of Georgia, P.C., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Obstetrix Medical Group Of Atlanta, LLC	GA	Maternal & Fetal Medicine Physician	$0	$10M
Ira Schachar	CA	Retina Specialist (Ophthalmology) Physician	$3.9M	$4.1M
Janet Davis	GA	Maternal & Fetal Medicine Physician	$0	$611.4K

Nearby Providers

Other providers in the same ZIP code as Pediatrix Medical Group Of Georgia, P.C., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pediatrix Medical Group Of South Carolina PA	FL	Neonatal-Perinatal Medicine Physician	$0	$51.3M
Pediatrix Medical Group Of Florida Inc	FL	Pediatric Cardiology Physician	$0	$35.9M
Pediatrix Medical Group Of Michigan PC	FL	Neonatal-Perinatal Medicine Physician	$0	$26.4M
Pediatrix Medical Group Of North Carolina PC	FL	Neonatal-Perinatal Medicine Physician	$0	$23.1M
Pediatrix Medical Group Of California, A Professional Corporation	FL	Neonatal-Perinatal Medicine Physician	$0	$10.8M
Kellee Campbell	FL	Podiatrist	$283.5K	$0
Dileep Ravi	FL	Emergency Medicine Physician	$142.5K	$0
Burak Ilsin	FL	Anesthesiology Physician	$60.4K	$0
Andrea Banta	FL	Certified Registered Nurse Anesthetist	$52.5K	$0
Will Crowthers	FL	Certified Registered Nurse Anesthetist	$51K	$0

Pediatrix Medical Group Of Georgia, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References