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

Why is the Medicaid comparison limited to Alabama 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. Alabama (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 Gastroenterology Associates PC (NPI 1407969371)

Field	Value
Entity Type	Organization
Organization	Pediatric Gastroenterology Associates PC
Address	303 Williams Avenue
City	Huntsville
State	AL
ZIP	35801
Taxonomy	Pediatric Gastroenterology Physician
NPI Enumerated	August 16, 2006

Payer Source	Total Paid
Medicaid	$2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99245	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a high level of medical decision making or the provider spends…	5,740	$140	$814.8K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	2,750	$210	$568.2K
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…	5,400	$90	$502.5K
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…	1,940	$80	$147.5K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alabama Distribution

Pediatric Gastroenterology Associates PC — 3 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. Alabama median

4 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…	618	1,990	680	$60	$201.7K
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…	10	330	140	$240	$197.4K
99245	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a high level of medical decision making or the provider spends…	2	30	120	$190	$175.5K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	2	60	110	$190	$74.7K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tennessee Valley Neonatology, Inc	AL	Neonatal-Perinatal Medicine Physician	$0	$22.2M
The Health Care Authority Of The City Of Huntsville	AL	General Acute Care Hospital	$0	$17.8M
Happi Health	AL	Federally Qualified Health Center (FQHC)	$0	$17.6M
Emergency Physicians Group	AL	Emergency Medicine Physician	$0	$13.5M
Healthgroup Of Alabama	AL	Contractor	$0	$13.4M
The Valley Foundation	AL	Multi-Specialty Clinic/Center	$0	$11.3M
David White	AL	Neurology Physician	$7M	$0
The Children's Hospital Of Alabama	AL	Pediatric Pulmonology Physician	$0	$5.6M
Huntsville Pediatric Associates, LLC	AL	Pediatrics Physician	$0	$4.8M
Dental Associates Of Huntsville, LLC	AL	General Practice Dentistry	$0	$4.7M

Pediatric Gastroenterology Associates PC — Billing Profile & Reimbursement Data

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Pediatric Gastroenterology Associates PC — Billing Profile & Reimbursement Data

Sign up for Pediatric Gastroenterology Associates PC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References