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

Why is the Medicaid comparison limited to Arizona 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. Arizona (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 Gps, Inc (NPI 1336758861)

Pediatrics Gps, Inc is a pediatrics physician provider located in Tucson, Arizona. This profile covers 0 Medicare and 49 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 Gps, Inc
Address	5861 N Oracle Rd
City	Tucson
State	AZ
ZIP	85704
Taxonomy	Pediatrics Physician
NPI Enumerated	July 30, 2020

Payer Source	Total Paid
Medicaid	$6.2M
Medicare	$0

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

49 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	25,320	$60	$1.5M
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…	17,530	$80	$1.4M
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.	17,870	$40	$786.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	8,880	$80	$728.2K
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…	7,140	$80	$599.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	6,540	$90	$582.4K
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…	5,160	$70	$376.3K
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.	4,320	$10	$60.5K
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…	2,330	$30	$58.2K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	2,300	$10	$32.2K

Showing 1–10 of 49

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Arizona Distribution

Pediatrics Gps, Inc — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arizona

Full comparison — all codes billed, vs. Arizona median

49 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…	225	3,040	750	$50	$343.9K
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…	135	2,780	600	$50	$267K
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.	27	420	600	$30	$177K
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…	38	300	860	$50	$165.9K
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…	29	300	690	$60	$155.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	18	310	470	$60	$131.9K
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…	708	930	200	$70	$97.7K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	15	300	270	$60	$90.1K
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,…	362	850	230	$40	$72.5K
99051	The provider sees a patient during regular office hours that occur outside of traditional office hours, i.e., in the evening, on a weekend, or on a holiday.	16	60	260	$10	$26K

Showing 1–10 of 49

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tmc Medical Network	AZ	Multi-Specialty Clinic/Center	$0	$20.3M
Catherine Benoit	AZ	Family Nurse Practitioner	$940	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Genesis Ob Gyn PLLC	AZ	Obstetrics & Gynecology Physician	$0	$21.7M
Rasw, PC	AZ	Retina Specialist (Ophthalmology) Physician	$0	$11.6M
Northwest Allied Physicians LLC	AZ	General Practice Physician	$0	$10.3M
Sonora Behavioral Health Hospital, LLC	AZ	Psychiatric Hospital	$0	$9.8M
Southern Arizona Urgent Care LLC	AZ	Urgent Care Clinic/Center	$0	$7.8M
Al Shaafi Medical PC	AZ	Pediatrics Physician	$0	$7.6M
Community Medical Services Arizona-private, LLC	AZ	Methadone Clinic	$0	$7.6M
Pima Heart Asc LLC	AZ	Ambulatory Surgical Clinic/Center	$3.7M	$59.7K
Ryan Wong	AZ	Retina Specialist (Ophthalmology) Physician	$2.8M	$0
Anthony Joseph	AZ	Retina Specialist (Ophthalmology) Physician	$2.2M	$0

Pediatrics Gps, Inc — Billing Profile & Reimbursement Data

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Pediatrics Gps, 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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