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

Why is the Medicaid comparison limited to Alabama 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. Alabama (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 Radiology Associates PC (NPI 1144268145)

Pediatric Radiology Associates PC is a pediatric radiology physician provider located in Birmingham, Alabama. This profile covers 0 Medicare and 51 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 Radiology Associates PC
Address	1600 7th Ave S
City	Birmingham
State	AL
ZIP	35233
Taxonomy	Pediatric Radiology Physician
NPI Enumerated	June 2, 2006

Payer Source	Total Paid
Medicaid	$6.8M
Medicare	$0

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

51 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	115,050	$10	$1M
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	54,130	$20	$812K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	13,900	$60	$792.3K
76770	A retroperitoneal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e.Kidneys, urinary bladder, and aorta). This particular code is used when the ultrasound is…	13,650	$50	$696.3K
70551	The provider uses magnetic resonance imaging, or MRI, to examine the brain and brain stem. The provider does not administer contrast for this exam.	6,930	$100	$685.9K
74018	Report this code for one X–ray view of the structures and organs in the abdomen to diagnose certain abdominal problems.	49,290	$10	$542.2K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	3,310	$150	$490K
74230	The provider visualizes and records the patient’s swallowing pattern using barium sulfate contrast and cineradiography/videoradiography; scout neck films and delayed images may be obtained and, if…	7,330	$40	$256.6K
74019	Report this code for two X–ray views of the structures and organs in the abdomen to diagnose certain abdominal problems.	12,740	$20	$203.8K
76705	An abdominal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. liver, gallbladder, pancreas, bile ducts, spleen, and abdominal aorta). This particular code…	5,340	$30	$181.5K

Showing 1–10 of 51

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alabama Distribution

Pediatric Radiology Associates PC — 18 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. Alabama median

51 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
76140	The provider reviews an X–ray image that was performed at another site and provides a written consultation report.	1	10	7,610	$20	$145.2K
74230	The provider visualizes and records the patient’s swallowing pattern using barium sulfate contrast and cineradiography/videoradiography; scout neck films and delayed images may be obtained and, if…	1	10	2,430	$30	$99K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	2	20	120	$180	$97.9K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	7	110	340	$30	$90.9K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	18	80	200	$40	$90.3K
76770	A retroperitoneal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e.Kidneys, urinary bladder, and aorta). This particular code is used when the ultrasound is…	1	20	250	$50	$72.4K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	4	160	1,080	$1	$46.7K
70551	The provider uses magnetic resonance imaging, or MRI, to examine the brain and brain stem. The provider does not administer contrast for this exam.	1	30	70	$100	$42.2K
76506	The provider performs a noninvasive diagnostic imaging technique, called echoencephalography, that uses ultrasound waves to examine, measure, and record the structures within the skull in real–time,…	2	10	1,110	$30	$41.8K
71260	In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the thorax using contrast material.	7	20	140	$40	$28.2K

Showing 1–10 of 51

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratory Corporation Of America Holdings	AL	Clinical Medical Laboratory	$60.5M	$289.1M
University Of Alabama Health Services Foundation, PC	AL	Pediatrics Physician	$0	$79.6M
University Of Alabama Health Services Foundation, PC.	AL	Multi-Specialty Clinic/Center	$0	$77.1M
The Children's Hospital Of Alabama	AL	Children's Hospital	$0	$59M
M&o Enterprises LLC	AL	Home Infusion Therapy Pharmacy	$0	$31.2M
Medical Resources, Inc	AL	Oxygen Equipment & Supplies (DME)	$0	$23.6M
Southern Lab Partners, LLC	AL	Clinical Medical Laboratory	$5.4M	$14.4M
University Of Alabama Health Services Foundation PC	AL	Clinic/Center	$0	$18.6M
Jefferson County Board Of Health	AL	Public Health or Welfare Agency	$0	$12.2M
The Children's Hospital Of Alabama	AL	Psychologist	$0	$12M

Pediatric Radiology Associates PC — Billing Profile & Reimbursement Data

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Pediatric Radiology Associates 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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