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

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

Wind River Pediatrics, LLC (NPI 1215976253)

Wind River Pediatrics, LLC is a pediatrics physician provider located in Riverton, Wyoming. This profile covers 0 Medicare and 21 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	Wind River Pediatrics, LLC
Address	1005 College View Dr
City	Riverton
State	WY
ZIP	82501
Taxonomy	Pediatrics Physician
NPI Enumerated	June 5, 2006

Payer Source	Total Paid
Medicaid	$476.3K
Medicare	$0

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

21 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…	5,220	$60	$318.7K
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…	490	$80	$38.4K
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…	280	$90	$24.9K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	1,690	$10	$21.9K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	930	$20	$20.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	180	$90	$17.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	200	$90	$16.7K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	330	$10	$4.5K
99203	The provider sees a new 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 provider…	40	$90	$3.5K
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.	250	$10	$3.4K

Showing 1–10 of 21

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wyoming Distribution

Wind River Pediatrics, LLC — 1 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wyoming

Full comparison — all codes billed, vs. Wyoming median

21 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…	189	220	400	$50	$79.3K
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…	25	260	420	$30	$67.2K
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…	16	50	280	$70	$43.2K
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…	14	40	170	$70	$34.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	11	30	100	$60	$17.8K
99203	The provider sees a new 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 provider…	28	60	40	$70	$15.1K
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,…	51	70	70	$20	$10.2K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	3	20	140	$20	$9.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	8	30	70	$60	$7.6K
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…	4	10	20	$10	$6.9K

Showing 1–10 of 21

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Entry Services	WY	Developmentally Disabled Services Day Training Agency	$0	$50.2M
Community Health Center Of Central Wyoming Inc	WY	Federally Qualified Health Center (FQHC)	$0	$4.3M
Frontier Ambulance LLC	WY	Ambulance	$737.8K	$785.4K
Guardian Flight LLC	WY	Air Ambulance	$934.9K	$0
Reach Foundation	WY	Case Management Agency	$0	$927.5K
Lincare Inc.	WY	Durable Medical Equipment & Medical Supplies	$0	$788K
Debra Stone	WY	Developmentally Disabled Services Day Training Agency	$0	$709.2K
Kinisha Pullen-shelsta	WY	Case Manager/Care Coordinator	$0	$661.2K
Riverton Vision Center P.C.	WY	Optometrist	$0	$606.2K
Wyoming Counseling Services PC	WY	Professional Counselor	$0	$595.8K

Wind River Pediatrics, LLC — Billing Profile & Reimbursement Data

Sign up for Wind River Pediatrics, LLC — Billing Profile & Reimbursement Data policy alerts

Wind River Pediatrics, LLC — Billing Profile & Reimbursement Data

Sign up for Wind River Pediatrics, LLC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References