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

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Robeson Pediatrics, P.A. (NPI 1497071526)

Robeson Pediatrics, P.A. is a pediatric adolescent medicine physician provider located in Lumberton, North Carolina. This profile covers 0 Medicare and 65 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	Robeson Pediatrics, P.A.
Address	3001 N Elm St
City	Lumberton
State	NC
ZIP	28358
Taxonomy	Pediatric Adolescent Medicine Physician
NPI Enumerated	April 14, 2010

Payer Source	Total Paid
Medicaid	$8.5M
Medicare	$0

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

65 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	28,650	$80	$2.2M
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	207,770	$10	$1.2M
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…	18,200	$60	$1M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	7,410	$80	$563K
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.	15,200	$40	$547.2K
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…	6,980	$70	$516.3K
99401	At an encounter separate from a preventive medicine visit, the provider offers counseling related to subjects appropriate for the patient’s age, family history, and areas of concern. The subjects…	13,900	$30	$361.5K
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…	4,450	$70	$324.5K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	8,850	$40	$309.8K
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.	23,680	$10	$284.1K

Showing 1–10 of 65

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Carolina Distribution

Robeson Pediatrics, P.A. — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

65 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	172	2,850	10,910	$10	$330.3K
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…	105	4,400	960	$60	$271.3K
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…	112	520	1,080	$80	$262.1K
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…	68	550	970	$90	$258.9K
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…	220	4,130	670	$50	$219.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	40	590	490	$90	$179.8K
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.	31	380	460	$40	$173.1K
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.	200	330	300	$10	$142.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	111	530	270	$90	$112.8K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	107	610	1,000	$10	$94.2K

Showing 1–10 of 65

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Primary Health Choice, Inc.	NC	Community/Behavioral Health Agency	$0	$93.3M
Children's Health Of Carolina, PA	NC	Pediatrics Physician	$0	$90.4M
A Primary Choice, Inc.	NC	In Home Supportive Care Agency	$0	$71.2M
Southeastern Regional Medical Center	NC	General Acute Care Hospital	$0	$28.8M
Southeastern Integrated Care	NC	Family Medicine Physician	$0	$23.9M
Charles Graham	NC	Personal Care Attendant	$0	$23.9M
Speech Solutions Inc	NC	Speech-Language Pathologist	$0	$19.2M
Stephens Outreach Center, Inc	NC	Community/Behavioral Health Agency	$0	$17.4M
A Primary Choice	NC	In Home Supportive Care Agency	$0	$15.6M
Premier Behavioral Services Inc	NC	Community/Behavioral Health Agency	$0	$14.6M

Robeson Pediatrics, P.A. — Billing Profile & Reimbursement Data

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Robeson Pediatrics, P.A. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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