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

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

Thompson River Pediatrics And Urgent Care, LLC (NPI 1497155089)

Thompson River Pediatrics And Urgent Care, LLC is a pediatrics physician provider located in Johnstown, Colorado. This profile covers 0 Medicare and 75 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	Thompson River Pediatrics And Urgent Care, LLC
Address	4435 Ronald Reagan Blvd.
City	Johnstown
State	CO
ZIP	80534
Taxonomy	Pediatrics Physician
NPI Enumerated	September 2, 2014

Payer Source	Total Paid
Medicaid	$8M
Medicare	$0

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

75 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…	24,690	$90	$2.1M
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	4,160	$340	$1.4M
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…	23,300	$60	$1.4M
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…	7,860	$90	$667.8K
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.	16,410	$40	$607.1K
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…	5,840	$80	$479.1K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	5,330	$60	$303.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	3,530	$80	$296.3K
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…	17,230	$20	$258.4K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	3,040	$30	$82K

Showing 1–10 of 75

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Thompson River Pediatrics And Urgent Care, LLC — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

75 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	86	2,520	330	$100	$352K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	94	310	1,750	$40	$319.9K
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…	57	2,630	430	$90	$268.2K
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	2	20	170	$290	$242.4K
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…	24	240	550	$110	$208.5K
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	260	380	$100	$161.6K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	298	690	140	$90	$118.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	25	290	160	$110	$111.1K
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…	452	720	130	$100	$110K
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.	12	330	530	$30	$100.6K

Showing 1–10 of 75

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Revelyn Arrogante	CO	Physical Medicine & Rehabilitation Physician	$294.3K	$0
Arete Surgical Center, LLC	CO	Ambulatory Surgical Clinic/Center	$280K	$0
Sarah Howe	CO	Nurse Practitioner	$246K	$0
Edward Donner	CO	Orthopaedic Surgery of the Spine Physician	$220K	$0
Professional Pharmacy Services	CO	Long Term Care Pharmacy	$87.5K	$95.2K
Jack Torres	CO	Physical Medicine & Rehabilitation Physician	$144K	$0
Aaron Mcgrew	CO	Medical Physician Assistant	$106.6K	$0
Harmony Imaging Center LLC	CO	Diagnostic Radiology Physician	$76.3K	$0
Christopher Kottenstette	CO	Medical Physician Assistant	$13K	$0

Thompson River Pediatrics And Urgent Care, LLC — Billing Profile & Reimbursement Data

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Thompson River Pediatrics And Urgent Care, 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

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