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

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

Pediatrics And Adolescent Medicine, P.C. (NPI 1033220108)

Pediatrics And Adolescent Medicine, P.C. is a pediatrics physician provider located in Orange, Connecticut. This profile covers 0 Medicare and 23 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	Pediatrics And Adolescent Medicine, P.C.
Address	240 Indian River Rd
City	Orange
State	CT
ZIP	06477
Taxonomy	Pediatrics Physician
NPI Enumerated	August 31, 2006

Payer Source	Total Paid
Medicaid	$1.1M
Medicare	$0

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

23 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…	11,440	$60	$675.1K
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.	3,460	$40	$148.7K
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…	1,430	$90	$125.8K
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…	450	$120	$52.1K
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…	230	$100	$23.8K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	980	$20	$23.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	160	$100	$16K
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.	1,730	$10	$13.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	60	$90	$5.7K
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…	50	$100	$5K

Showing 1–10 of 23

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Connecticut Distribution

Pediatrics And Adolescent Medicine, P.C. — 0 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Connecticut

Full comparison — all codes billed, vs. Connecticut median

23 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	616	1,590	740	$50	$331.8K
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…	174	1,710	750	$30	$243.3K
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…	115	170	850	$80	$203.5K
92587	Code 92587 is in the Medicine/Special Otorhinolaryngologic Services Section. It involves special procedures of the ears/nose/throat. This code is for screening purposes with interpretation and…	48	50	280	$90	$175.9K
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…	132	160	680	$70	$166.1K
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.	87	240	1,560	$20	$159.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	118	180	710	$70	$151.2K
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…	140	380	220	$70	$99.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	132	170	410	$70	$98K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	255	290	470	$10	$41.9K

Showing 1–10 of 23

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
New Solutions Pain Management Clinic LLC	CT	Nurse Practitioner	$0	$9.2M
Med-aid LLC	CT	Durable Medical Equipment & Medical Supplies	$0	$2.8M
Ldo, LLC	CT	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.9M
Impact Health P.C.	CT	Nurse Practitioner	$0	$1.4M
Lung Docs Of Ct PC	CT	Pulmonary Disease Physician	$0	$1.3M
Laura Scanlon	CT	Optometrist	$0	$1.1M
Ambulatory Dental Anesthesia Associates, LLC	CT	General Practice Dentistry	$0	$1.1M
Jeffrey Reynolds	CT	Nephrology Physician	$160.6K	$0
Jillian Reid	CT	Adult Health Nurse Practitioner	$157.2K	$0
Bayode Afolalu	CT	Nephrology Physician	$141.6K	$0

Pediatrics And Adolescent Medicine, P.C. — Billing Profile & Reimbursement Data

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Pediatrics And Adolescent Medicine, P.C. — 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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