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

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

Pediatrics, Inc. (NPI 1255358065)

Pediatrics, Inc. is a pediatrics physician provider located in Glen Allen, Virginia. This profile covers 0 Medicare and 67 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	Pediatrics, Inc.
Address	10571 Telegraph Road
City	Glen Allen
State	VA
ZIP	23059
Taxonomy	Pediatrics Physician
NPI Enumerated	July 16, 2006

Payer Source	Total Paid
Medicaid	$11.3M
Medicare	$0

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

67 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…	54,200	$90	$4.7M
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…	33,320	$60	$2M
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…	8,890	$80	$702K
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…	8,690	$70	$625.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	7,700	$80	$600.3K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	10,150	$40	$385.7K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	4,280	$80	$355.2K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	31,250	$10	$250K
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.	22,080	$10	$220.8K
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.	14,870	$10	$193.2K

Showing 1–10 of 67

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

Pediatrics, Inc. — 19 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

67 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…	36	3,520	370	$70	$280.7K
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…	79	4,010	290	$50	$199.8K
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…	26	650	150	$80	$115.4K
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…	18	580	150	$70	$109K
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…	170	210	390	$50	$106.2K
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…	173	610	150	$90	$104K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	17	630	110	$80	$78.1K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	279	610	70	$110	$68.1K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	1	370	210	$40	$62.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	10	430	160	$80	$60.2K

Showing 1–10 of 67

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Maxim Healthcare Services, Inc.	VA	Home Health Agency	$0	$72.7M
Kidmed Inc.	VA	Urgent Care Clinic/Center	$0	$17.4M
Bhg Xlii, LLC	VA	Substance Use Disorder Rehabilitation Clinic/Center	$94.7K	$10M
Intercept Youth Services, Inc.	VA	Community/Behavioral Health Agency	$0	$10M
Peter Minneci	VA	Family Medicine Physician	$547.2K	$0
Virginia Cvs Pharmacy, L.L.C.	VA	Pharmacy	$201.6K	$0
Yiping Rao	VA	Gastroenterology Physician	$156.8K	$0
Cherine Reid	VA	Chiropractor	$111K	$0
Jessica Joyce	VA	Physician Assistant	$108.9K	$0
Kristin Gingrich	VA	Podiatrist	$106.9K	$0

Pediatrics, Inc. — Billing Profile & Reimbursement Data

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Pediatrics, Inc. — 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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