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

Why is the Medicaid comparison limited to New Mexico 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. New Mexico (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.

Journey Pediatrics PC (NPI 1205205630)

Journey Pediatrics PC is a primary care clinic/center provider located in Albuquerque, New Mexico. 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	Journey Pediatrics PC
Address	8308 Constitution Pl Ne
City	Albuquerque
State	NM
ZIP	87110
Taxonomy	Primary Care Clinic/Center
NPI Enumerated	September 16, 2015

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
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…	21,210	$70	$1.4M
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…	10,790	$110	$1.2M
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.	19,730	$50	$907.4K
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…	11,430	$70	$822.9K
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…	7,600	$100	$783K
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…	5,160	$110	$541.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5,020	$100	$512K
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…	11,250	$20	$236.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,070	$100	$208.9K
92551	The provider delivers a limited series of tones or sounds to a patient to determine if the patient’s hearing is in an acceptable range to detect hearing problems.	3,620	$10	$39.8K

Showing 1–10 of 51

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Mexico Distribution

Journey Pediatrics PC — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. New Mexico median

51 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…	60	930	910	$80	$521.6K
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…	88	960	1,010	$90	$490K
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…	15	100	1,100	$110	$362K
0241U	N/A	27	30	1,080	$150	$353.2K
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…	9	120	670	$110	$301.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	12	120	430	$110	$205.4K
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…	10	110	610	$40	$148.2K
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…	206	320	220	$110	$146.2K
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.	9	150	660	$30	$123.7K
99177	The provider uses instruments to conduct a vision screening exam to analyze both eyes to diagnose ocular or eye–related diseases. Both the screening and analysis take place on–site.	7	20	1,180	$30	$123.5K

Showing 1–10 of 51

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
1st Care Of New Mexico LLC	NM	In Home Supportive Care Agency	$0	$86.5M
Community Options, Inc	NM	Child Intellectual and/or Developmental Disabilities Respite Care	$0	$76.7M
Abarim Home Health Care Inc.	NM	Community Based Hospice Care Agency	$0	$66M
New Mexico Department Of Health	NM	Customized Equipment (DME)	$0	$60.4M
Independent Living Resource Center	NM	Personal Care Attendant	$0	$57.7M
Ability First, LLC	NM	Exclusive Provider Organization	$0	$49M
Alta Mira Specialized Family Services, Inc.	NM	Community/Behavioral Health Agency	$0	$46.2M
Southwest Family Guidance Center LLC	NM	Adolescent and Children Mental Health Clinic/Center	$0	$32.7M
Aid Home Health Care Services LLC.	NM	Home Health Agency	$0	$32.4M
Active Solutions Incorporated	NM	Developmentally Disabled Services Day Training Agency	$0	$31.3M

Journey Pediatrics PC — Billing Profile & Reimbursement Data

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Journey 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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