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.

Nuestros Ninos Our Kids Pediatrics Inc. (NPI 1972756732)

Key Findings

Field	Value
Entity Type	Organization
Organization	Nuestros Ninos Our Kids Pediatrics Inc.
Address	777 Franklin Rd Se
City	Marietta
State	GA
ZIP	30067
Taxonomy	Pediatric Nurse Practitioner
NPI Enumerated	October 24, 2008

Payer Source	Total Paid
Medicaid	$11.4M
Medicare	$0

This practice has no Medicare billing on file and reports $11.4M in lifetime Medicaid revenue, making it effectively a single-payer (Medicaid) outpatient pediatric provider in the data. Analysts should treat Medicaid as the material payer for any downstream contracting or utilization analysis rather than split payer strategies.

Revenue is highly concentrated: the precomputed top three Medicaid codes (99214, 99213, 99393) together account for 43.2% of the provider’s total Medicaid revenue. The single highest-paid code is 99214 ($2.3M, 21.0% of Medicaid revenue), followed by 99213 ($1.3M, 11.8%) and 99393 ($1.2M, 10.4%), indicating that a limited set of visit types drives nearly half of Medicaid receipts.

The code mix indicates a primary focus on pediatric primary care and preventive services: high-volume preventive visit codes 99393 (11.8K claims, $1.2M) and 99394 (9K claims, $962.5K) are among top earners, and 90460 vaccine administration (23.4K claims, $1.1M) is also a major revenue line. These patterns are consistent with a practice that delivers routine well-child care and immunizations as a core business line rather than specialty procedural care.

High volumes of established outpatient E/M visits further define day-to-day operations: 99214 (25.5K claims, $2.3M), 99213 (21.2K claims, $1.3M), and 99212 (19.9K claims, $737.6K) together represent substantial clinical throughput. Each of these E/M codes ranks well above peers in Georgia (99214 at the 97th percentile and 99213 at the 95th percentile), signaling consistently heavy use of moderate- and low-complexity office visits.

The practice delivers broad point-of-care testing and ancillary preventive services on-site, evidenced by very large counts for rapid strep testing 87880 (21.2K claims, $296.9K) and influenza testing 87804 (7.5K claims, $195.4K), plus 87426 COVID testing (3.1K claims, $110.1K). Additional preventive/ancillary lines such as audiology testing 92588 (5.9K claims, $100.3K; ranks #1 of 9, 100th percentile) and fluoride application 99188 (6K claims, $96.2K) point to a comprehensive clinic model that bundles basic diagnostics and preventive procedures.

Operational signals point to an extended-hours or high-access model: after-hours/expanded-hours codes 99051 (12.1K claims, $205.4K) and 99050 (3K claims, $60.8K) appear routinely, and very high vaccine administration counts (90460, 23.4K claims) support a walk-in immunization or school-entry vaccine throughput. These patterns are consistent with a high-volume pediatric primary care site that prioritizes access and throughput.

Competitive standing in-state is strong for preventive pediatric care and select ancillary services: 99393 ranks #3 of 173 providers in Georgia (99th percentile) and 99394 ranks #4 of 157 (98th percentile), both labeled as "extreme outlier" volumes. Multiple other codes (99214 at 97th, 99212 at 98th, 90460 at 97th) are described as "notably above typical state volume," which together indicate this provider is a major regional player for well-child visits and related services.

The provider has established tenure in the Medicare/Medicaid ecosystem with NPI enumeration on 2008-10-24 (~18 years ago), indicating long-term operation in the market. That longevity combined with revenue concentration (top three codes = 43.2% of Medicaid revenue) suggests both institutional stability and potential sensitivity to policy or reimbursement changes that affect pediatric preventive and E/M visit payments.

Medicaid: Complete Services Breakdown

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

69 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…	25,500	$90	$2.3M
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…	21,220	$60	$1.3M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	11,800	$100	$1.2M
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…	11,660	$100	$1.1M
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.	23,450	$50	$1.1M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	9,000	$110	$962.5K
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,…	19,930	$40	$737.6K
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…	8,670	$80	$685.2K
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.	21,210	$10	$296.9K
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.	12,090	$20	$205.4K

Showing 1–10 of 69

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

Nuestros Ninos Our Kids Pediatrics Inc. — 14 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

69 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…	51	920	370	$60	$360.6K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	25	40	1,100	$20	$287.1K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	24	40	1,160	$20	$275.9K
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…	29	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…	7	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…	11	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.	9	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.	3	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,…	9	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…	259	310	90	$90	$136.3K

Showing 1–10 of 69

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Optum Women's And Children's Health, LLC	GA	Durable Medical Equipment & Medical Supplies	$0	$160.4M
Tara Pursely	GA	Dentist	$0	$1.5M
Healthtrackrx Of Georgia LLC	GA	Clinical Medical Laboratory	$0	$1.3M
Ocmulgee Medical Pathology Association Inc	GA	Clinical Medical Laboratory	$958.1K	$84.9K
Atlanta Area Psychological Associates, P.C.	GA	Psychologist	$0	$1M
Kayla Dawson	GA	General Practice Dentistry	$0	$969.5K
Alan Gardner	GA	Dermatology Physician	$800.1K	$0
Northwest Georgia Orthopaedic Surgery Center, LLC	GA	Ambulatory Surgical Clinic/Center	$641K	$0
Shaun Lewis	GA	Professional Counselor	$0	$601.3K
Gi Diagnostics Endoscopy Center, LLC	GA	Endoscopy Clinic/Center	$571.3K	$0

Nuestros Ninos Our Kids Pediatrics Inc. — Billing Profile & Reimbursement Data

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Nuestros Ninos Our Kids Pediatrics Inc. — 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