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.

The Pediatric Center (NPI 1528003365)

The Pediatric Center is a pediatrics physician provider located in Wellington, Florida. This profile covers 0 Medicare and 60 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	The Pediatric Center
Address	1447 Medical Park Blvd.
City	Wellington
State	FL
ZIP	33414
Taxonomy	Pediatrics Physician
NPI Enumerated	June 17, 2006

Payer Source	Total Paid
Medicaid	$7.4M
Medicare	$0

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

60 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…	38,130	$60	$2.3M
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…	20,060	$90	$1.7M
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…	6,010	$130	$757.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	4,180	$130	$547.1K
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…	4,440	$110	$492.7K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,580	$140	$358.9K
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.	20,250	$20	$303.7K
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,…	8,490	$30	$263.1K
92553	The provider presents the patient with a series of tones at varying intensities to identify the softest level at which the patient can hear to access hearing and determine the type and amount of…	11,650	$10	$139.8K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	2,140	$50	$102.8K

Showing 1–10 of 60

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

The Pediatric Center — 6 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

60 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	40	40	830	$100	$785.9K
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…	93	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…	105	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…	106	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.	104	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…	128	6,380	430	$50	$139.3K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	115	170	300	$60	$121.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	96	980	360	$80	$97.2K
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…	170	820	1,430	$1	$92.8K
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.	587	880	610	$30	$71.7K

Showing 1–10 of 60

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wellington Regional Medical Center LLC	FL	General Acute Care Hospital	$0	$10.7M
Kevin Kelly	FL	Retina Specialist (Ophthalmology) Physician	$2.8M	$0
Daniel Brodtman	FL	Allergy & Immunology Physician	$514.9K	$746.4K
Todd Gersten	FL	Medical Oncology Physician	$1.1M	$0
Eliezer Hernandez	FL	Cardiovascular Disease Physician	$550.8K	$380.1K
Berry Pierre	FL	Internal Medicine Physician	$597.7K	$0
Gavin Hart	FL	Orthopaedic Surgery Physician	$405.2K	$0
Venkatachalam Shanmugasundaram	FL	Otolaryngology Physician	$51.4K	$314.6K
Nicholas Sama	FL	Orthopaedic Trauma Physician	$237.1K	$0
Lila Saidian	FL	Diagnostic Radiology Physician	$224.6K	$0

The Pediatric Center — Billing Profile & Reimbursement Data

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The Pediatric Center — 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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