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

Why is the Medicaid comparison limited to Ohio 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. Ohio (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 Assoicates, Inc. (NPI 1457346090)

Pediatric Assoicates, Inc. is a pediatrics physician provider located in Canal Winchester, Ohio. This profile covers 0 Medicare and 80 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	Pediatric Assoicates, Inc.
Address	7750 Diley Road Suite A
City	Canal Winchester
State	OH
ZIP	43110
Taxonomy	Pediatrics Physician
NPI Enumerated	September 20, 2005

Payer Source	Total Paid
Medicaid	$14.4M
Medicare	$0

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

80 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…	89,600	$40	$3.9M
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…	45,120	$70	$2.9M
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.	90,060	$30	$2.5M
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…	25,480	$60	$1.5M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	18,990	$60	$1.1M
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…	15,940	$50	$812.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	6,980	$60	$433K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	6,910	$30	$234.8K
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…	22,800	$10	$182.4K
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	12,070	$10	$144.8K

Showing 1–10 of 80

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Ohio Distribution

Pediatric Assoicates, Inc. — 15 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

80 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	1,451	2,640	620	$90	$408.2K
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…	106	4,510	500	$60	$377.8K
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…	62	5,080	560	$40	$323.9K
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…	21	430	560	$60	$303.2K
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…	11	480	450	$70	$292.9K
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…	7	270	420	$90	$276K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	94	140	140	$160	$266.4K
94640	The provider administers oxygen under pressure or not under pressure to open obstructed air passages. He uses any of the listed devices to treat a patient with an acute obstruction of the airway that…	243	250	710	$110	$209K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	12	480	280	$70	$181.7K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	231	280	1,450	$10	$178.3K

Showing 1–10 of 80

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ohiohealth Corporation	OH	Family Medicine Physician	$0	$89.1M
Pallavy Reddy	OH	Endocrinology, Diabetes & Metabolism Physician	$351.6K	$0
Jeffrey Schwein	OH	Foot & Ankle Surgery Podiatrist	$145.2K	$0
Benjamin Swisher	OH	Family Medicine Physician	$64.9K	$42.1K
Andrew Stein	OH	Otolaryngic Allergy Physician	$87.6K	$200
Brock Liden	OH	Primary Podiatric Medicine Podiatrist	$64K	$280
Scott Yoho	OH	Psychiatry Physician	$51.9K	$280
Bj Pomerants	OH	Surgery Physician	$43K	$0
Nicholas Mischel	MI	Psychiatry Physician	$29.8K	$0
Kerry Stedke	OH	Physician Assistant	$5.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
David Whitt	OH	Internal Medicine Physician	$413.3K	$24.5K
Bethany Sheldon	OH	Physician Assistant	$65.2K	$0
Robin Franz	OH	Family Medicine Physician	$64.5K	$0
Gideon King	OH	Family Medicine Physician	$63.7K	$0
Amrita Karve	OH	Cardiovascular Disease Physician	$59.7K	$0
Duncan Legg	OH	Family Medicine Physician	$28.8K	$0
Karen Keener	OH	Registered Dietitian	$4.9K	$0

Pediatric Assoicates, Inc. — Billing Profile & Reimbursement Data

Sign up for Pediatric Assoicates, Inc. — Billing Profile & Reimbursement Data policy alerts

Pediatric Assoicates, Inc. — Billing Profile & Reimbursement Data

Sign up for Pediatric Assoicates, 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