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

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

Pettit Pediatrics LLC (NPI 1518435452)

Pettit Pediatrics LLC is a pediatrics physician provider located in Vernal, Utah. This profile covers 0 Medicare and 39 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	Pettit Pediatrics LLC
Address	1360 W Highway 40
City	Vernal
State	UT
ZIP	84078
Taxonomy	Pediatrics Physician
NPI Enumerated	November 8, 2018

Payer Source	Total Paid
Medicaid	$871K
Medicare	$0

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

39 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…	5,880	$70	$405.9K
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…	1,720	$100	$168.7K
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…	1,340	$100	$128.7K
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…	600	$100	$59.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	390	$80	$32.3K
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,…	430	$40	$18.6K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	2,890	$10	$17.4K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	2,130	$10	$12.8K
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.	330	$30	$9.1K
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…	200	$40	$7.7K

Showing 1–10 of 39

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Utah Distribution

Pettit Pediatrics LLC — 0 of 22 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Utah

Full comparison — all codes billed, vs. Utah median

39 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…	427	1,340	200	$80	$144K
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…	79	1,360	190	$70	$125K
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…	28	220	200	$80	$74K
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…	27	190	150	$80	$58.1K
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…	196	290	100	$70	$37.1K
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,…	33	170	80	$100	$35.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	40	150	60	$70	$32.2K
36416	In this procedure, the provider pricks the patient’s finger, heel, or ear with a pointed instrument and collects specimen of droplets of blood by pressing the pricking site.	49	70	290	$20	$27.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	60	90	90	$60	$22.4K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	41	50	130	$40	$21K

Showing 1–10 of 39

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Uintah Basin Tri-county Mental Health And Substance Abuse Local Author	UT	Community/Behavioral Health Agency	$0	$11.4M
Ashley Valley Medical Center LLC	UT	General Acute Care Hospital	$0	$4.4M
Eastern Utah Early Intervention, Inc.	UT	Developmentally Disabled Services Day Training Agency	$0	$1.7M
The Er Group, LLC	UT	Emergency Medicine Physician	$0	$1.4M
Learning Solutions LLC	UT	Adolescent and Children Mental Health Clinic/Center	$0	$1.3M
White Smiles Pediatric Dentistry	UT	Pediatric Dentistry	$0	$1.2M
Vernal Urgent Care LLC	UT	Urgent Care Clinic/Center	$0	$1.2M
Kolby Lance	UT	Pediatric Dentistry	$0	$992.1K
Dinosaurland Pediatrics	UT	Specialist	$0	$989K
Uintah Basin Tri-county Mental Health And Substance Abuse Local Author	UT	Community/Behavioral Health Agency	$0	$824K

Pettit Pediatrics LLC — Billing Profile & Reimbursement Data

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Pettit Pediatrics 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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