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

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

Priority Care Pediatrics, LLC (NPI 1033157664)

Priority Care Pediatrics, LLC is a pediatrics physician provider located in Kansas City, Missouri. This profile covers 0 Medicare and 43 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	Priority Care Pediatrics, LLC
Address	9405 N Oak Trfy
City	Kansas City
State	MO
ZIP	64155
Taxonomy	Pediatrics Physician
NPI Enumerated	June 4, 2006

Payer Source	Total Paid
Medicaid	$5.9M
Medicare	$0

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

43 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…	30,810	$80	$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…	20,830	$50	$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…	10,410	$80	$791.3K
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…	9,860	$70	$710.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	4,670	$70	$336K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	930	$140	$126.1K
90698	This code represents a combination vaccine product administered into the muscle to protect against five diseases: diphtheria, tetanus, pertussis, Haemophilus influenzae type b (Hib), and polio.	4,370	$30	$118K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	410	$110	$45.5K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	7,380	$10	$44.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	470	$70	$34.3K

Showing 1–10 of 43

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

Priority Care Pediatrics, LLC — 15 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

43 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	8	30	120	$100	$165.4K
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…	32	3,170	230	$70	$128.1K
94760	The provider takes a single measurement of the patient’s oxygen saturation using a sensor on the ear or finger.	11	30	220	$170	$116.4K
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	4,310	300	$60	$110.8K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	174	440	250	$70	$71.8K
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…	6	680	280	$90	$65.3K
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…	182	420	90	$100	$60.2K
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…	6	640	210	$90	$59.5K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	495	1,060	250	$40	$57.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	8	600	110	$90	$40.2K

Showing 1–10 of 43

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eye Surgery Center-northland LLC	MO	Ambulatory Surgical Clinic/Center	$243.2K	$0
Berent Krumm	MO	Family Medicine Physician	$175K	$0
Costco Wholesale Corporation	MO	Community/Retail Pharmacy	$119.5K	$0
Todd Fox	MO	Family Medicine Physician	$119.2K	$0
Charla Webb	MO	Family Nurse Practitioner	$76.2K	$0
Janet James	MO	Family Medicine Physician	$71.9K	$0
Maureen Lopez	MO	Speech-Language Pathologist	$63K	$0
Stephanie Haupt	MO	Family Medicine Physician	$52.2K	$0
Sara Deffenbaugh	MO	Family Medicine Physician	$50K	$0
Hannah Kacerovskis	MO	Physical Therapist	$45.9K	$0

Priority Care Pediatrics, LLC — Billing Profile & Reimbursement Data

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Priority Care Pediatrics, 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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