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

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Calvary Pediatrics (NPI 1285999458)

Calvary Pediatrics is a pediatrics physician provider located in Fayetteville, North Carolina. This profile covers 0 Medicare and 90 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	Calvary Pediatrics
Address	509 Sandhurst Dr
City	Fayetteville
State	NC
ZIP	28304
Taxonomy	Pediatrics Physician
NPI Enumerated	July 12, 2012

Payer Source	Total Paid
Medicaid	$7.8M
Medicare	$0

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

90 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…	14,580	$90	$1.3M
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…	19,640	$60	$1.2M
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	178,710	$10	$1.1M
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…	7,420	$90	$682.8K
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…	7,690	$90	$677K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	6,250	$90	$569K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,770	$100	$276.8K
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.	14,090	$20	$267.6K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	9,370	$30	$262.4K
92587	Code 92587 is in the Medicine/Special Otorhinolaryngologic Services Section. It involves special procedures of the ears/nose/throat. This code is for screening purposes with interpretation and…	11,210	$20	$179.3K

Showing 1–10 of 90

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Carolina Distribution

Calvary Pediatrics — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

90 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	105	160	840	$70	$2.3M
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	201	2,850	10,910	$10	$330.3K
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…	294	4,400	960	$60	$271.3K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	77	90	320	$160	$262.5K
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…	60	520	1,080	$80	$262.1K
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…	60	550	970	$90	$258.9K
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…	205	4,130	670	$50	$219.9K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	70	100	200	$150	$212.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	55	590	490	$90	$179.8K
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.	34	380	460	$40	$173.1K

Showing 1–10 of 90

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cumberland County Hospital System Inc	NC	General Acute Care Hospital	$0	$75.8M
Bayada Home Health Care, Inc.	NC	Home Health Agency	$0	$32.8M
Valleygate Dental Surgery Center Of Fayetteville, LLC	NC	Ambulatory Surgical Clinic/Center	$0	$26.5M
Cfvhs Ed Physicians	NC	Emergency Medicine Physician	$0	$26.2M
Rafael Rivera, Jr., Dds, PLLC	NC	Dentist	$0	$14.2M
Pediatric Developmental Therapy	NC	Speech-Language Pathologist	$0	$12.1M
Cumberland County Hospital System Inc	NC	Internal Medicine Physician	$0	$8M
Children's Health Of Carolina, PA	NC	Pediatrics Physician	$0	$7.6M
Chauncy Nelson	NC	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$7.4M
Fayetteville Ambulatory Surgery Center LLC	NC	Ambulatory Surgical Clinic/Center	$1.4M	$2.2M

Calvary Pediatrics — Billing Profile & Reimbursement Data

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Calvary Pediatrics — 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