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

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

Rocky Mountain Health Centers Pediatrics, PC (NPI 1063614535)

Rocky Mountain Health Centers Pediatrics, PC is a pediatric adolescent medicine physician provider located in Aurora, Colorado. This profile covers 0 Medicare and 72 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	Rocky Mountain Health Centers Pediatrics, PC
Address	14001 E Iliff Ave Ste 210
City	Aurora
State	CO
ZIP	80014
Taxonomy	Pediatric Adolescent Medicine Physician
NPI Enumerated	June 5, 2007

Payer Source	Total Paid
Medicaid	$4.6M
Medicare	$0

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

72 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…	15,520	$70	$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.	16,130	$40	$677.4K
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…	6,190	$100	$594K
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…	6,010	$90	$522.5K
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…	5,280	$90	$485.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	4,150	$90	$381.4K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	11,340	$20	$181.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1,750	$100	$173.4K
99173	The provider checks the eyesight in both eyes of a pediatric patient by asking him to read letters of varying sizes on a standard chart, such as a Snellen’s chart, which he keeps 20 feet away from…	10,380	$10	$83K
G8510	Screening for depression is documented as negative, a follow-up plan is not required	5,730	$10	$63K

Showing 1–10 of 72

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Rocky Mountain Health Centers Pediatrics, PC — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

72 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…	124	2,520	330	$100	$352K
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…	284	2,630	430	$90	$268.2K
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…	21	240	550	$110	$208.5K
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…	18	260	380	$100	$161.6K
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…	516	590	200	$80	$119.9K
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,…	98	690	140	$90	$118.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	22	290	160	$110	$111.1K
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.	13	330	530	$30	$100.6K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	18	280	510	$30	$77.4K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	74	130	290	$10	$67.3K

Showing 1–10 of 72

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Teamselect Home Care Of Colorado, LLC	CO	Home Health Agency	$0	$194.9M
Clinton Home Care, Inc.	CO	In Home Supportive Care Agency	$0	$60.3M
Smith Agency	CO	Foster Care Agency	$0	$51.9M
Colorado Spirit Home Care	CO	In Home Supportive Care Agency	$0	$46.9M
Alternative Choice Home Care Nursing, LLC	CO	Home Health Agency	$0	$42.7M
Care On Call Colorado, LLC	CO	In Home Supportive Care Agency	$0	$33.8M
Atlas Home Health, Inc.	CO	Home Health Agency	$0	$31.3M
Mercy Home Services	CO	In Home Supportive Care Agency	$0	$27.9M
Community Support Services, Inc.	CO	Developmentally Disabled Services Day Training Agency	$0	$27M
Support Management	CO	Developmentally Disabled Services Day Training Agency	$0	$26.2M

Rocky Mountain Health Centers Pediatrics, PC — Billing Profile & Reimbursement Data

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Rocky Mountain Health Centers Pediatrics, PC — 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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References