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

Why is the Medicaid comparison limited to Vermont 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. Vermont (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 Medicine, Plc (NPI 1487701140)

Field	Value
Entity Type	Organization
Organization	Pediatric Medicine, Plc
Address	52 Timber Ln
City	South Burlington
State	VT
ZIP	05403
Taxonomy	Pediatrics Physician
NPI Enumerated	January 4, 2007

Payer Source	Total Paid
Medicaid	$355.3K
Medicare	$0

Medicaid: Complete Services Breakdown

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

12 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…	4,250	$40	$148.7K
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…	2,390	$50	$121.7K
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.	3,130	$20	$65.7K
G9001	Coordinated care fee, initial rate	220	$30	$6.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	150	$40	$6.2K
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…	670	$1	$2K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	60	$30	$1.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	30	$70	$1.9K
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	20	$30	$580
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.	10	$20	$200

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Vermont Distribution

Pediatric Medicine, Plc — 0 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Vermont

Full comparison — all codes billed, vs. Vermont median

12 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…	101	320	680	$30	$146.1K
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…	67	320	760	$20	$88.2K
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.	13	40	890	$10	$32.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	28	40	290	$20	$16K
G9001	Coordinated care fee, initial rate	11	20	230	$20	$15.6K
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	29	40	210	$30	$13.7K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	23	30	360	$10	$11.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	28	30	210	$20	$8.9K
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.	46	50	250	$10	$7.3K
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	30	240	$1	$2.9K

Showing 1–10 of 12

Nearby Providers

Other providers in the same ZIP code as Pediatric Medicine, Plc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nfi Vermont, Inc	VT	Clinic/Center	$0	$33.6M
Bla Partners, LLC	VT	Clinical Medical Laboratory	$0	$15.2M
Timberlane Dental Group	VT	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$7.5M
Tms Vt, LLC	VT	Durable Medical Equipment & Medical Supplies	$0	$2.9M
Michelle Young	VT	Ophthalmology Physician	$2.1M	$0
Howard Center Inc	VT	Psychiatry Physician	$0	$2M
Vermont Eye Surgery & Laser Center	VT	Ambulatory Surgical Clinic/Center	$1.8M	$2.7K
David Weissgold	VT	Ophthalmology Physician	$1.7M	$0
Surgi-care Inc	VT	Prosthetic/Orthotic Supplier	$0	$1.7M
City Of So Burlington	VT	Ambulance	$400.9K	$1M

Pediatric Medicine, Plc — Billing Profile & Reimbursement Data

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Pediatric Medicine, Plc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References