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

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

Evergreen Pediatrics PLLC (NPI 1184885675)

Evergreen Pediatrics PLLC is a primary care clinic/center provider located in Kirkland, Washington. 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	Evergreen Pediatrics PLLC
Address	433 State St S Ste 1
City	Kirkland
State	WA
ZIP	98033
Taxonomy	Primary Care Clinic/Center
NPI Enumerated	June 18, 2008

Payer Source	Total Paid
Medicaid	$2.5M
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
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…	11,950	$70	$824.2K
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…	7,680	$100	$775.2K
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…	3,010	$90	$255.8K
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…	2,270	$90	$208.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,340	$90	$124.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	580	$100	$58.1K
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,…	1,660	$30	$51.4K
99381	The provider performs a well–baby visit for a child under the age of one.	270	$90	$23.9K
99174	The provider uses instruments to conduct a vision screening exam on both eyes. The procedure includes analysis and report.	5,420	$1	$21.7K
36416	In this procedure, the provider pricks the patient’s finger, heel, or ear with a pointed instrument and collects specimen of droplets of blood by pressing the pricking site.	6,560	$1	$19.7K

Showing 1–10 of 51

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Washington Distribution

Evergreen Pediatrics PLLC — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. Washington median

51 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…	240	1,820	480	$60	$379.6K
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…	219	1,860	610	$40	$295.5K
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…	57	280	540	$70	$166.5K
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…	68	300	400	$80	$164.4K
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…	452	540	130	$90	$128.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	76	320	290	$70	$104.8K
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	700	180	$50	$59.3K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	29	60	230	$20	$55.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	67	280	110	$70	$45.2K
94640	The provider administers oxygen under pressure or not under pressure to open obstructed air passages. He uses any of the listed devices to treat a patient with an acute obstruction of the airway that…	110	130	440	$10	$26.3K

Showing 1–10 of 51

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kestra Medical Technology Services, Inc.	WA	Durable Medical Equipment & Medical Supplies	$0	$3.8M
Crystal Birdsong	WA	Nurse Practitioner	$2M	$0
City Of Kirkland	WA	Land Ambulance	$244.6K	$298.5K
Aesthetic Eye Associates, Ps	WA	Ambulatory Surgical Clinic/Center	$337.1K	$0
Susan Kim	WA	Dermatology Physician	$242.4K	$0
Frank Marinkovich	WA	Internal Medicine Physician	$235.4K	$0
Costco Wholesale Corporation	WA	Community/Retail Pharmacy	$224.7K	$0
Steven Laukaitis	WA	Ophthalmology Physician	$154K	$0
Sean Batson	WA	Ophthalmology Physician	$138.2K	$0
Keith Cummings	WA	Sports Medicine (Physical Medicine & Rehabilitation) Physician	$114.1K	$0

Evergreen Pediatrics PLLC — Billing Profile & Reimbursement Data

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Evergreen Pediatrics PLLC — 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