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

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

Children's Hospital Pediatric Associates, Inc (NPI 1457306664)

Children's Hospital Pediatric Associates, Inc is a pediatrics physician provider located in Boston, Massachusetts. This profile covers 0 Medicare and 66 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	Children's Hospital Pediatric Associates, Inc
Address	300 Longwood Ave
City	Boston
State	MA
ZIP	02115
Taxonomy	Pediatrics Physician
NPI Enumerated	May 24, 2006

Payer Source	Total Paid
Medicaid	$19.1M
Medicare	$0

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

66 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	73,110	$90	$6.8M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	59,130	$50	$3M
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…	39,770	$70	$2.8M
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…	18,710	$100	$1.8M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	7,320	$140	$1M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	7,890	$70	$568K
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…	3,410	$120	$418.9K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	3,270	$100	$310.5K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	3,040	$90	$282.3K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	3,030	$80	$251.3K

Showing 1–10 of 66

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Children's Hospital Pediatric Associates, Inc — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

66 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	86	520	120	$130	$1M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	24	550	110	$120	$865.5K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	353	410	140	$110	$742.2K
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.	89	120	530	$450	$681.5K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	19	830	130	$120	$671K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	1,153	1,620	580	$80	$599.6K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	98	160	270	$130	$469.1K
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,…	48	50	320	$530	$379.3K
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.	7	10	150	$970	$360.3K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	132	230	330	$70	$343.3K

Showing 1–10 of 66

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Hospital Corporation	MA	Children's Hospital	$0	$330.9M
Kee Chung	MA	Pediatric Radiology Physician	$207.1K	$107.4K
Thaddeus Herliczek	MA	Pediatric Radiology Physician	$38.7K	$264K
Nutan Sharma	MA	Neurology Physician	$286K	$0
Jeffrey Sorkin	MA	Ophthalmology Physician	$24.9K	$251.2K
Thomas Tadros	MA	Clinical Cardiac Electrophysiology Physician	$160.8K	$0
Nimesh Patel	MA	Ophthalmology Physician	$140.4K	$8K
Francisco Bonilla	MA	Allergy & Immunology Physician	$71.3K	$52.5K
Lisa Teot	MA	Anatomic Pathology Physician	$23.5K	$63.9K
Kevin Friedman	CO	Pediatric Cardiology Physician	$790	$68.1K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Brigham & Womens Hospital, Inc.	MA	General Acute Care Hospital	$0	$252.7M
Brigham & Womens Physicians Organization Inc	MA	Internal Medicine Physician	$0	$43.6M
Roman Klufas	MA	Neuroradiology Physician	$475.7K	$441.9K
Paul Massey	MA	MOHS-Micrographic Surgery Physician	$621.3K	$0
John Chi	MA	Neurological Surgery Physician	$444.6K	$0
An Bui	MA	Internal Medicine Physician	$410.9K	$0
Mohammadali Mojarrad	MA	Diagnostic Radiology Physician	$343.4K	$40.3K
James Kang	MA	Orthopaedic Surgery Physician	$371.1K	$0
Monica Krishnan	MA	Radiation Oncology Physician	$340.4K	$0
Joseph Kavolus	MA	Orthopaedic Surgery Physician	$306.9K	$0

Children's Hospital Pediatric Associates, Inc — Billing Profile & Reimbursement Data

Sign up for Children's Hospital Pediatric Associates, Inc — Billing Profile & Reimbursement Data policy alerts

Children's Hospital Pediatric Associates, Inc — Billing Profile & Reimbursement Data

Sign up for Children's Hospital Pediatric Associates, Inc — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References