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

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

Pediatric Associates (NPI 1295921534)

Field	Value
Entity Type	Organization
Organization	Pediatric Associates
Address	2401 Blueridge Ave
City	Wheaton
State	MD
ZIP	20902
Taxonomy	Primary Care Clinic/Center
NPI Enumerated	September 20, 2007

Payer Source	Total Paid
Medicaid	$6.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

60 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…	16,120	$120	$1.9M
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…	19,000	$80	$1.6M
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…	6,710	$100	$657.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	4,850	$110	$513.7K
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…	4,480	$110	$470.3K
0241U	N/A	2,480	$130	$315.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,240	$110	$255.2K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	9,820	$20	$216.1K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	6,620	$30	$165.4K
92552	The provider assesses a patient’s hearing with a series of tones at varying intensities to identify the lowest threshold at which the patient can hear.	5,940	$20	$142.4K

Showing 1–10 of 60

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maryland Distribution

Pediatric Associates — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. Maryland median

60 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…	120	3,670	680	$90	$310K
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…	122	3,280	610	$80	$296.1K
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…	30	330	800	$110	$228.7K
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…	15	290	730	$100	$212.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	22	350	490	$110	$172.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	52	320	290	$120	$128K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	16	40	460	$80	$103.6K
0241U	N/A	7	70	250	$90	$85.2K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	63	250	320	$30	$82.2K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	109	870	700	$20	$79.7K

Showing 1–10 of 60

Nearby Providers

Other providers in the same ZIP code as Pediatric Associates, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Capital Care, Inc	MD	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$101.9M
Cornerstone Montgomery, Inc.	MD	Community/Behavioral Health Agency	$0	$29.5M
Kidz & Family Dental Center	MD	Dental Clinic/Center	$0	$13.3M
Smile Care 4 Children, LLC	MD	Pediatric Dentistry	$0	$10.5M
C Arefi B Nasehi & Associates PC	MD	General Practice Dentistry	$0	$7M
Right Care Pediatrics Inc	MD	Pediatrics Physician	$0	$5.3M
Derm Associates LLC	MD	Dermatology Physician	$5.1M	$11K
Virant Diagnostics, Inc	MD	Clinical Medical Laboratory	$48.8K	$4.3M
Frederick Min	MD	Hematology & Oncology Physician	$3.2M	$0
Alan Matsumoto	MD	Rheumatology Physician	$2.2M	$0

Pediatric Associates — Billing Profile & Reimbursement Data

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Pediatric Associates — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References