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

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

Fairmont Pediatrics And Associates (NPI 1144405762)

Fairmont Pediatrics And Associates is a pediatrics physician provider located in Pasadena, Texas. This profile covers 0 Medicare and 179 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	Fairmont Pediatrics And Associates
Address	4002 Burke Rd Ste 200
City	Pasadena
State	TX
ZIP	77504
Taxonomy	Pediatrics Physician
NPI Enumerated	January 2, 2008

Payer Source	Total Paid
Medicaid	$11.5M
Medicare	$0

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

179 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…	49,950	$50	$2.6M
99000	Use this code for the in office preparation of a specimen for lab analysis and or its transport from the office to the outside testing laboratory.	93,750	$10	$1.1M
95012	The provider performs a test involving nitric oxide exhaled by a patient into a nitric oxide monitoring system. The test helps with checking the level of inflammation in the airways of a patient who…	55,480	$20	$832.1K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	59,220	$10	$829K
94010	The provider or technician administers a spirometry test to assess the patient's respiratory function. The spirometer is attached to a computer that records the total and timed vital capacity…	30,040	$20	$660.9K
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…	5,090	$80	$402.4K
98960	A nonphysician qualified healthcare professional uses a standard curriculum to educate a patient about their disease or disorder and how to manage it more effectively. This code represents each 30…	44,060	$10	$352.5K
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…	4,670	$70	$345.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	4,030	$80	$338.5K
96112	The provider administers various standardized tests to diagnose developmental problems in children. He interprets the results and prepares a report. Report this code for the first hour of test…	3,990	$80	$307.2K

Showing 1–10 of 179

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Texas Distribution

Fairmont Pediatrics And Associates — 16 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. Texas median

179 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1013	Sign language or oral interpretive services, per 15 minutes	21	30	210	$630	$1.5M
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	62	240	420	$30	$296.8K
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…	916	6,040	710	$40	$232.8K
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…	188	1,500	880	$80	$185.8K
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…	160	1,360	800	$80	$185.6K
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…	41	5,810	540	$50	$155.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	168	1,540	650	$80	$150.4K
96131	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	169	200	220	$160	$145.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	124	1,540	360	$80	$110.6K
96112	The provider administers various standardized tests to diagnose developmental problems in children. He interprets the results and prepares a report. Report this code for the first hour of test…	5	60	320	$80	$89.8K

Showing 1–10 of 179

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chca Bayshore LP	TX	General Acute Care Hospital	$0	$46.9M
Chartwell Community Services Inc.	TX	Home Health Agency	$0	$38.4M
New Dimensions Caregivers LLC	TX	Home Health Agency	$0	$11M
Bayshore Health Mart, Inc.	TX	Community/Retail Pharmacy	$5.4M	$380
Burke Family Pharmacy Inc	TX	Community/Retail Pharmacy	$3.8M	$0
Naveed Saqib	TX	Vascular Surgery Physician	$611.7K	$0
Ashkan Ghorbani	TX	Dermatology Physician	$566.7K	$0
Dixie Melillo	TX	Diagnostic Radiology Physician	$429.3K	$0
Lawrence Clarke	TX	Otolaryngic Allergy Physician	$333.2K	$0
Jojy George	TX	Surgery Physician	$319.6K	$0

Fairmont Pediatrics And Associates — Billing Profile & Reimbursement Data

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Fairmont Pediatrics And Associates — 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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