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.

Pm Pediatrics Of Maryland (NPI 1306238647)

Key Findings

Field	Value
Entity Type	Organization
Organization	Pm Pediatrics Of Maryland
Address	7401 Greenbelt Rd
City	Greenbelt
State	MD
ZIP	20770
Taxonomy	Urgent Care Clinic/Center
NPI Enumerated	February 24, 2015

Payer Source	Total Paid
Medicaid	$33.5M
Medicare	$0

This provider is effectively single‑payer at the federal-program level: there is no Medicare billing on file and all recorded federal program revenue is from Medicaid, totaling $33.5M. The absence of Medicare activity means analyses of senior care or dual-eligible mix will not apply and the provider’s Medicaid footprint fully reflects its public payer exposure.

Revenue is highly concentrated in a small set of codes: the precomputed top three Medicaid codes account for 88.6% of this provider’s total Medicaid revenue. Those top drivers are S9083, 99214, and 99213, which together dominate the $33.5M Medicaid revenue base and indicate a narrow set of services producing the majority of income.

S9083 is the single largest revenue line and indicates an urgent‑care operational model: S9083 generated $13.2M from 127.8K claims at $103 avg paid/claim (39.3% of total Medicaid revenue). This large volume for the global fee for urgent care centers, combined with high counts of E/M visits, points to a high-throughput urgent‑care or walk‑in clinic business rather than a procedure- or specialty-driven practice.

E/M services (office/outpatient visits) are the other dominant revenue streams: 99214 produced $8.6M from 88.9K claims at $97 avg paid/claim (25.8% of Medicaid revenue) and 99213 produced $7.9M from 90.6K claims at $87 avg paid/claim (23.6% of Medicaid revenue). The prominence of these established‑patient E/M codes suggests routine evaluation and management visits are the core clinical activity supporting revenue.

State competitive standing is extreme for key lines: S9083 ranks #1 of 70 providers in‑state (100th percentile, extreme outlier) and both 99214 and 99213 rank in the 100th percentile (#13 of 3673 and #16 of 3275, respectively; labeled extreme outliers). These rank/percentile positions indicate the provider is a dominant, high-volume player statewide for urgent care global fees and common E/M visits.

There is meaningful new‑patient throughput as well: 99203 ($2.1M from 34K claims, 6.4% of Medicaid revenue) and 99204 ($1.6M from 17.6K claims, 4.8% of Medicaid revenue) are material contributors and rank #3 and #4 in‑state (100th percentile). The presence of substantial new‑patient visit revenue alongside heavy established‑patient volume suggests both intake of new patients and repeat outpatient care are part of the operating model.

Ancillary testing and treatment codes generate only a small fraction of revenue relative to visits: for example, 87880 generated $6.6K (2.2K claims at $3 avg), and COVID/respiratory antigen codes such as 87426 and 87428 each produced only a few thousand dollars. This mix implies that point‑of‑care visit fees, not lab or ancillary services, drive the Medicaid financial profile.

Several codes show nontrivial claim counts but report $0 avg paid/claim and $0 revenue on file (for example, 99051 with 2.9K claims, 99072 with 1.1K claims, and Q0162 with 786 claims). These entries create observable claim activity without recorded Medicaid revenue in the file and should be noted when reconciling billed services versus paid Medicaid line items.

Medicaid: Complete Services Breakdown

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

27 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S9083	Global fee urgent care centers	127,750	$100	$13.2M
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…	88,910	$100	$8.6M
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…	90,650	$90	$7.9M
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…	34,040	$60	$2.1M
99204	The provider sees a new 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 provider…	17,570	$90	$1.6M
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	280	$40	$10.5K
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.	2,200	$1	$6.6K
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…	40	$160	$6.6K
99201	Deleted code, effective Jan. 1, 2021	30	$90	$3.1K
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,…	630	$1	$2.5K

Showing 1–10 of 27

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

Pm Pediatrics Of Maryland — 5 of 18 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

27 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S9083	Global fee urgent care centers	1	70	7,000	$120	$1.8M
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…	13	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…	16	3,280	610	$80	$296.1K
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…	777	1,000	200	$120	$96.3K
99204	The provider sees a new 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 provider…	4	930	110	$100	$90.1K
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,…	105	250	320	$30	$82.2K
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…	3	730	110	$70	$81.9K
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,…	760	900	160	$60	$57.8K
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…	65	100	610	$10	$42.1K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	64	190	80	$50	$31.4K

Showing 1–10 of 27

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Medstar Health Visiting Nurse Association, Inc.	MD	Home Health Agency	$0	$21.6M
Advanced Behavioral Health, Inc.	MD	Child & Adolescent Psychiatry Physician	$0	$20.2M
Families First Counseling And Psychiatry, LLC	MD	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$19.9M
The Retina Group Of Washington, PLLC	MD	Ophthalmology Physician	$0	$19.5M
Maxim Healthcare Services, Inc.	MD	Home Health Agency	$0	$19.2M
Volunteers Of America Chesapeake & Carolinas, Inc	MD	Voluntary or Charitable Agency	$0	$16.4M
Capital Hospice	MD	Community Based Hospice Care Agency	$0	$15.8M
Maryland Health Alliance, Inc.	MD	Mental Health Counselor	$0	$13.1M
Elites Care LLC	MD	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$12.7M
Neurological Medicine, P.A.	MD	Neurology Physician	$0	$9.2M

Pm Pediatrics Of Maryland — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References