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

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

Pediatria Healthcare, LLC (NPI 1447492269)

Field	Value
Entity Type	Organization
Organization	Pediatria Healthcare, LLC
Address	53 Gravel St
City	Wilkes Barre
State	PA
ZIP	18705
Taxonomy	Medically Fragile Infants and Children Day Care
NPI Enumerated	March 25, 2009

Payer Source	Total Paid
Medicaid	$14M
Medicare	$0

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S9123	Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)	21,820	$350	$7.5M
T1002	Rn services, up to 15 minutes	18,580	$350	$6.4M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

Pediatria Healthcare, LLC — 1 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S9123	Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)	6	70	4,620	$530	$4M
T1002	Rn services, up to 15 minutes	2	90	1,850	$400	$1.5M

Related Providers

Other providers that share a Tax Identification Number (TIN) with Pediatria Healthcare, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pediatria Healthcare, LLC	MA	Home Health Agency	$0	$47.8M
Pediatria Healthcare, LLC	PA	Home Health Agency	$0	$13.9M
Pediatria Healthcare LLC	GA	Nursing Care Agency	$0	$11.1M
Pediatria Healthcare, LLC	LA	Medically Fragile Infants and Children Day Care	$0	$9.8M

Nearby Providers

Other providers in the same ZIP code as Pediatria Healthcare, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Maxim Healthcare Services, Inc.	PA	Home Health Agency	$0	$5.7M
City Of Wilkes Barre	PA	Land Ambulance	$404.2K	$2.9M
Frank Cawley	PA	Orthopedic Physical Therapist	$1.1M	$6.5K
John Ellis	PA	Cardiovascular Disease Physician	$432.3K	$0
David Dalessandro	PA	Cardiovascular Disease Physician	$422K	$0
Sheehans Pharmacy Inc	PA	Community/Retail Pharmacy	$310.3K	$150
Walter Delgaudio	PA	Urology Physician	$215.7K	$0
Robert Fiorelli	PA	Urology Physician	$205.9K	$0
Eugene Kim	PA	Orthopaedic Surgery Physician	$199.3K	$0
David Cooper	PA	Sports Medicine (Neuromusculoskeletal Medicine) Physician	$179.2K	$0

Pediatria Healthcare, LLC — Billing Profile & Reimbursement Data

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Pediatria Healthcare, LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References