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

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

Orlando Pediatric Pulmonary And Sleep Associates PA (NPI 1316010952)

Orlando Pediatric Pulmonary And Sleep Associates PA is a pediatric pulmonology physician provider located in Winter Park, Florida. This profile covers 0 Medicare and 38 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	Orlando Pediatric Pulmonary And Sleep Associates PA
Address	2660 W Fairbanks Ave
City	Winter Park
State	FL
ZIP	32789
Taxonomy	Pediatric Pulmonology Physician
NPI Enumerated	November 15, 2006

Payer Source	Total Paid
Medicaid	$32.9M
Medicare	$0

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

38 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	10,250	$820	$8.4M
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…	69,090	$120	$8.1M
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	13,290	$540	$7.2M
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…	50,750	$80	$4.2M
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…	8,780	$150	$1.3M
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…	6,660	$90	$626.4K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	4,300	$130	$550K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	2,290	$190	$425.6K
94010	The provider or technician administers a spirometry test to assess the patient's respiratory function. The spirometer is attached to a computer that records the total and timed vital capacity…	39,390	$10	$393.9K
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…	1,870	$160	$305K

Showing 1–10 of 38

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Florida Distribution

Orlando Pediatric Pulmonary And Sleep Associates PA — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Florida

Full comparison — all codes billed, vs. Florida median

38 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J2357	Injection, omalizumab, 5 mg	2	10	750	$1,070	$763K
90378	Immunoglobulin is a very complex protein that is produced by certain cells in the body to protect it from various types of infections and produce passive immunity. RSV–IgIM (respiratory syncytial…	1	10	500	$950	$650.8K
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	1	30	310	$720	$616.3K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	1	80	150	$440	$271.5K
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.	56	100	310	$130	$216.9K
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…	67	5,930	460	$40	$169.3K
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…	22	6,380	430	$50	$139.3K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	21	220	150	$160	$117.4K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	8	150	150	$110	$107.6K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	31	160	140	$150	$97.6K

Showing 1–10 of 38

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pediatric Services Of America, LLC	FL	Home Health Agency	$0	$33.5M
Csi Nurse World, Inc.	FL	Attendant Care Provider	$0	$11.2M
William Grow	FL	Medical Oncology Physician	$2.9M	$0
Yaman Suleiman	FL	Medical Oncology Physician	$2.3M	$0
Jamie Cesaretti	FL	Radiation Oncology Physician	$2.1M	$0
Vijitha Reddy	FL	Diagnostic Radiology Physician	$1.5M	$0
David Molthrop	FL	Medical Oncology Physician	$1.4M	$0
National Surgical Centers Of America LLC	FL	Ambulatory Surgical Clinic/Center	$1.3M	$1.6K
Winter Park Surgery Center LP	FL	Ambulatory Surgical Clinic/Center	$796.7K	$0
Javier Tello	FL	Infectious Disease Physician	$580K	$0

Orlando Pediatric Pulmonary And Sleep Associates PA — Billing Profile & Reimbursement Data

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Orlando Pediatric Pulmonary And Sleep Associates PA — 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