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 District of Columbia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to District of Columbia 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. District of Columbia (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.

Pediatric Professionals, PC (NPI 1093976813)

Pediatric Professionals, PC is a pediatrics physician provider located in Washington, District of Columbia. This profile covers 0 Medicare and 30 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	Pediatric Professionals, PC
Address	106 Irving St Nw
City	Washington
State	DC
ZIP	20010
Taxonomy	Pediatrics Physician
NPI Enumerated	June 24, 2008

Payer Source	Total Paid
Medicaid	$3.6M
Medicare	$0

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

30 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…	6,800	$120	$823.3K
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…	6,960	$70	$494.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	4,510	$110	$491.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	3,690	$120	$431.6K
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…	3,580	$110	$400.6K
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…	2,870	$100	$296K
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.	13,350	$20	$280.3K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	7,470	$20	$119.5K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	6,770	$20	$108.4K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	3,440	$10	$48.1K

Showing 1–10 of 30

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. District of Columbia Distribution

Pediatric Professionals, PC — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — District of Columbia

Full comparison — all codes billed, vs. District of Columbia median

30 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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	30	350	$110	$345.1K
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…	38	310	750	$70	$321.6K
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…	6	20	620	$110	$314.3K
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…	47	320	620	$50	$313.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5	40	330	$100	$251.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	3	30	140	$110	$134.3K
99381	The provider performs a well–baby visit for a child under the age of one.	8	10	170	$110	$65.7K
90651	This code represents a nonavalent human papillomavirus (HPV) vaccine product administered into the muscle to protect against HPV infection. The vaccine protects against nine HPV types (6, 11, 16, 18,…	5	10	240	$120	$46.8K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	28	40	270	$80	$39.7K
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	40	250	$10	$39.5K

Showing 1–10 of 30

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Hospital	DC	Children's Hospital	$0	$243.1M
Medstar Washington Hospital Center	DC	General Acute Care Hospital	$0	$239M
Children's Hospital	DC	Pediatrics Physician	$0	$115.3M
Whc Physician Group LLC	DC	General Practice Physician	$0	$93.8M
Medstar Medical Group Radiology, LLC	DC	Diagnostic Radiology Physician	$0	$17.5M
National Rehabilitation Hospital Inc	DC	Rehabilitation Hospital	$0	$16.9M
Hero Dental Of Washington Dc PC	DC	General Practice Dentistry	$0	$11.7M
Medstar Heart Institute LLC	DC	Surgery Physician	$0	$4.8M
Bio-medical Applications Of Columbia Heights, Inc.	DC	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.6M
Washington Hospital Center Corp	DC	General Practice Physician	$0	$3.7M

Pediatric Professionals, PC — Billing Profile & Reimbursement Data

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Pediatric Professionals, 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