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

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

University Of Maryland Pediatric Associates, PA (NPI 1528163912)

Key Findings

Field	Value
Entity Type	Organization
Organization	University Of Maryland Pediatric Associates, PA
Address	22 S Greene St
City	Baltimore
State	MD
ZIP	21201
Taxonomy	Pediatrics Physician
NPI Enumerated	September 13, 2006

Payer Source	Total Paid
Medicaid	$25.7M
Medicare	$0

This provider reports no Medicare billing on file and is effectively a single-payer Medicaid operation, with Total Medicaid revenue of $25.7M. The absence of Medicare revenue suggests payer exposure is concentrated in Medicaid without a measurable Medicare footprint to compare against.

Revenue concentration is high: the precomputed top 3 Medicaid codes account for 41.0% of this provider's total Medicaid revenue, driven primarily by 99284 (13.8%), 99469 (13.6%), and 99214 (13.6%). This indicates a small set of service lines produce a large share of Medicaid dollars and should be central to business planning and utilization review.

The code mix points to a pediatric practice structured around emergency/urgent evaluation and management, newborn/neonatal critical care, and higher-complexity outpatient medicine. High-volume codes include emergency department visits (99284, 99283, 99282), neonatal critical care and newborn management (99469, 99479, 99472, 99480, 99468, 99460), and established outpatient visit codes (99214, 99215, 99213), implying integrated acute and newborn services rather than only well-child primary care.

Competitive standing within Maryland is strong for several specialized pediatric services: 99469 ranks #1 of 8 providers in-state (100th percentile) and is described as notably above typical state volume, while 99479 ranks #1 of 10 providers in-state (100th percentile) and 99472 ranks #1 of 5 providers in-state (100th percentile). These positions indicate the provider is a leading state-level participant in newborn and neonatal critical care services.

The practice is an extreme outlier on select high-complexity visit codes for Medicaid: 99215 is an extreme outlier, far above typical state volume (ranks #4 of 1000 providers in-state, 100th percentile) and 99282 is also labeled an extreme outlier, far above typical state volume (ranks #2 of 75 providers in-state, 99th percentile). These outlier designations suggest unusually large volumes of high-acuity outpatient or ED-level pediatric encounters relative to peers.

There is also a notable footprint in pediatric echocardiography and cardiac imaging: 93303 ranks #1 of 9 providers in-state (100th percentile) and 93320 ranks #1 of 11 providers in-state (100th percentile), with combined revenue contributions visible among the top-25 codes. This pattern supports the view that the provider operates or affiliates with pediatric cardiology services or a high-volume imaging program within its Medicaid population.

For broadly used evaluation codes, the provider shows high but more typical participation: 99214 contributes $3.3M (13.6% of Medicaid revenue) and ranks #46 of 3673 providers in-state (99th percentile) as notably above typical state volume, while 99284 contributes $3.3M (13.8%) and ranks #12 of 153 providers in-state (93th percentile) with a characterization of typical, unremarkable volume for that ED code. This combination reflects both dominant volumes in some outpatient visit levels and more expected volumes for certain ED services.

The practice has been enumerated for a sustained period, with NPI registration dated 2006-09-13 (~20 years ago), indicating long tenure in the market which may underpin the high state-level rankings in neonatal, ED, and pediatric specialty services. Sustained presence combined with concentrated Medicaid revenue suggests established referral and service pathways focused on pediatric acute and newborn care.

Medicaid: Complete Services Breakdown

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

95 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	28,090	$120	$3.3M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	8,150	$410	$3.3M
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…	28,020	$120	$3.3M
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…	14,940	$170	$2.5M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	12,480	$130	$1.6M
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…	16,290	$70	$1.2M
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…	14,020	$70	$981.7K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	11,670	$80	$956.7K
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	11,690	$70	$865.1K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	7,260	$100	$725.7K

Showing 1–10 of 95

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maryland Distribution

University Of Maryland Pediatric Associates, PA — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. Maryland median

95 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0025	Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior)	5	10	5,340	$360	$4.3M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	12	150	1,540	$100	$1.2M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	68	150	760	$130	$964.3K
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	1	10	170	$360	$964.1K
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	1	10	2,880	$100	$358.7K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	10	150	940	$70	$345.1K
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…	46	3,670	680	$90	$310K
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…	187	3,280	610	$80	$296.1K
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	1	10	140	$110	$294.5K
99468	The provider evaluates and manages the initial care of a newborn or infant less than 28 days of age in a neonatal critical care setting.	2	10	180	$880	$271.7K

Showing 1–10 of 95

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dan Kunaprayoon	MD	Radiation Oncology Physician	$1.1M	$0
Sara Dudley	MD	Radiation Oncology Physician	$651K	$0
Melissa Hawkins Holt	MD	Rheumatology Physician	$254.3K	$0
Michael Slack	MD	Pediatric Cardiology Physician	$12.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chase Brexton Health Services, Inc.	MD	Federally Qualified Health Center (FQHC)	$0	$87.3M
University Of Maryland Community Medical Group, Inc.	MD	Family Medicine Physician	$0	$30.5M
Helping Hands Therapeutic Services, Inc	MD	Rehabilitation Clinic/Center	$0	$15.1M
Nursing And Health Services Training Consultants Inc.	MD	Nursing Care Agency	$0	$14.8M
Glass Health Programs, Inc.	MD	Substance Use Disorder Rehabilitation Clinic/Center	$339.2K	$13.3M
Glass Health Programs, Inc.	MD	Methadone Clinic	$711.9K	$12.8M
Empowering Minds Resource Center	MD	Community/Behavioral Health Agency	$0	$12.6M
University Of Maryland Emergency Medicine Associates, PA	MD	Emergency Medicine Physician	$0	$11.6M
University Of Md Obstetrical And Gynecological Asso. PA	MD	Obstetrics & Gynecology Physician	$0	$11.5M
University Of Maryland Diagnostic Imaging Specialists P A	MD	Diagnostic Radiology Physician	$0	$10.6M

University Of Maryland Pediatric Associates, PA — Billing Profile & Reimbursement Data

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University Of Maryland Pediatric Associates, PA — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References