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

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

Pm Pediatrics PA (NPI 1508071374)

Pm Pediatrics PA is a pediatrics physician provider located in Kissimmee, Florida. This profile covers 0 Medicare and 70 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

(source: NPPES NPI Registry)

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Pm Pediatrics PA
Address	1412 W Vine St
City	Kissimmee
State	FL
ZIP	34741
Taxonomy	Pediatrics Physician
NPI Enumerated	May 14, 2007

Payer Source	Total Paid
Medicaid	$7.7M
Medicare	$0

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

70 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…	40,970	$60	$2.4M
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.	29,930	$30	$837.9K
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…	10,860	$80	$814.6K
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…	8,590	$80	$661.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	9,430	$70	$640.9K
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…	7,490	$80	$613.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	6,190	$70	$446K
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,…	5,000	$50	$249.8K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	6,120	$30	$202K
97802	The provider treats medical conditions and related symptoms using specific diet therapy by interacting individually with the patient. This code represents each 15 minutes of the first visit with the…	23,180	$10	$185.4K

Showing 1–10 of 70

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Florida Distribution

Pm Pediatrics PA — 13 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Florida

Full comparison — all codes billed, vs. Florida median

70 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	36	1,130	780	$90	$210.4K
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…	48	1,050	640	$80	$183.6K
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…	93	5,930	460	$40	$169.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	24	1,120	520	$80	$141.7K
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…	443	6,380	430	$50	$139.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	21	980	360	$80	$97.2K
85018	The lab analyst measures the hemoglobin in a whole blood sample. Hemoglobin is the red pigmented iron compound contained in the red blood cell that combines with oxygen needed by the body tissue.	461	880	610	$30	$71.7K
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.	29	1,140	1,240	$10	$70.8K
99203	The provider sees a new 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 provider…	593	1,670	90	$80	$69.2K
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.	95	590	130	$40	$51.9K

Showing 1–10 of 70

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
First Step Therapy, LLC	FL	Clinic/Center	$0	$31.7M
Osceola Mental Health Inc	FL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$19.3M
Osceola Regional Hospital, Inc.	FL	General Acute Care Hospital	$0	$18.5M
Sunapee Dialysis LLC	FL	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$17.4M
Loop Pediatrics, PA	FL	Pediatrics Physician	$0	$14.2M
Cruz Homecare & Educational Services LLC	FL	Home Health Agency	$0	$13.2M
Carrousel Therapy Center Corporation	FL	Forensic Psychiatry Physician	$0	$10.9M
True Help Services Inc.	FL	Developmentally Disabled Services Day Training Agency	$0	$10.8M
North Star Counseling Of Central Florida, LLC.	FL	Mental Health Counselor	$0	$10.6M
Total Care Home Services, Inc.	FL	Home Health Agency	$0	$10.5M

Pm Pediatrics PA — Billing Profile & Reimbursement Data

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Pm Pediatrics PA — 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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