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

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

Childrens Lung Specialists (NPI 1518916451)

Childrens Lung Specialists is a pediatric pulmonology physician provider located in Las Vegas, Nevada. This profile covers 0 Medicare and 27 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	Childrens Lung Specialists
Address	3196 S Maryland Pkwy Ste 209
City	Las Vegas
State	NV
ZIP	89109
Taxonomy	Pediatric Pulmonology Physician
NPI Enumerated	May 8, 2006

Payer Source	Total Paid
Medicaid	$8.6M
Medicare	$0

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

27 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…	35,200	$80	$2.8M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	42,900	$60	$2.7M
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	1,320	$700	$925.8K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	4,000	$150	$595.7K
94010	The provider or technician administers a spirometry test to assess the patient's respiratory function. The spirometer is attached to a computer that records the total and timed vital capacity…	18,190	$30	$491.2K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	1,670	$240	$398.2K
99252	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a straightforward level of medical decision making or the provider…	2,880	$60	$169.9K
31624	In this procedure, the provider uses a rigid or flexible bronchoscope for bronchial alveolar lavage, a procedure using saline solution to wash the cells from alveoli, the air sacs at the end of the…	920	$140	$131.1K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	4,490	$30	$112.3K
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…	1,380	$60	$80.2K

Showing 1–10 of 27

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nevada Distribution

Childrens Lung Specialists — 9 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nevada

Full comparison — all codes billed, vs. Nevada median

27 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	1	10	270	$680	$394.9K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	4	20	380	$370	$237.8K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	17	430	500	$40	$214.4K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	58	140	690	$40	$145.2K
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…	19	2,250	290	$60	$138K
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…	583	2,480	330	$50	$107.6K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	4	80	80	$150	$91.2K
J2182	Injection, mepolizumab, 1 mg	2	10	40	$1,990	$73.5K
97803	The provider reassesses the dietary needs of a patient and uses specific diet therapy to treat medical conditions and related symptoms by interacting individually with the patient. This code…	28	40	220	$20	$66.1K
99204	The provider sees a new 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 provider…	257	780	90	$100	$46.6K

Showing 1–10 of 27

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sunrise Hospital And Medical Center, LLC	NV	General Acute Care Hospital	$0	$85.9M
Fremont Emergency Services Scherr Ltd	NV	Emergency Medicine Physician	$0	$20.9M
Sunrise Hospital And Medical Center, LLC	NV	General Acute Care Hospital	$0	$17.1M
Sanjay Kandoth Md PC	NV	Pediatrics Physician	$0	$14.6M
Sdmi, LLC	NV	Diagnostic Radiology Physician	$0	$14.3M
Harold Zilberman M D Chtd	NV	Pediatrics Physician	$0	$14.3M
Radiology Specialists Ltd Marasso-miller	NV	Diagnostic Radiology Physician	$0	$13.9M
1st Love & Life Caregivers, LLC	NV	In Home Supportive Care Agency	$0	$10.8M
Jlk Home Care, Inc	NV	In Home Supportive Care Agency	$0	$5.1M
Elsa Home Care Inc	NV	In Home Supportive Care Agency	$0	$4.8M

Childrens Lung Specialists — Billing Profile & Reimbursement Data

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Childrens Lung Specialists — 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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