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

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

Pediatric Associates Of Charlottesville (NPI 1528178787)

Pediatric Associates Of Charlottesville is a pediatrics physician provider located in Charlottesville, Virginia. This profile covers 0 Medicare and 65 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	Pediatric Associates Of Charlottesville
Address	1011 E Jefferson St
City	Charlottesville
State	VA
ZIP	22902
Taxonomy	Pediatrics Physician
NPI Enumerated	August 30, 2006

Payer Source	Total Paid
Medicaid	$6.1M
Medicare	$0

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

65 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…	47,840	$60	$2.8M
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…	15,360	$80	$1.3M
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…	5,620	$80	$438K
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…	5,080	$70	$365.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	4,030	$80	$306.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1,750	$80	$144.8K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	12,020	$10	$144.2K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	4,230	$10	$55K
90677	This code represents a vaccine product administered intramuscularly to protect against pneumococcal disease, a bacterial infection. This is a 20–valent vaccine, protecting against 20 strains of the…	330	$160	$54.4K
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	1,870	$30	$52.5K

Showing 1–10 of 65

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

Pediatric Associates Of Charlottesville — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

65 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…	165	3,520	370	$70	$280.7K
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…	48	4,010	290	$50	$199.8K
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…	50	650	150	$80	$115.4K
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	580	150	$70	$109K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	47	630	110	$80	$78.1K
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,…	323	980	140	$70	$70.9K
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.	294	440	170	$30	$67.4K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	133	150	120	$40	$64.7K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	240	370	210	$40	$62.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	59	430	160	$80	$60.2K

Showing 1–10 of 65

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Arc Of The Piedmont, Inc.	VA	Speech/Language/Hearing Specialist/Technologist	$0	$29M
Saferide Medical Transport LLC	VA	Non-emergency Medical Transport (VAN)	$0	$6.8M
County Of Albemarle	VA	Land Ambulance	$1.5M	$1.3M
John Hendrix	VA	MOHS-Micrographic Surgery Physician	$574.5K	$0
Jennifer Tromberg	VA	MOHS-Micrographic Surgery Physician	$422.4K	$0
Hina Qureshi	VA	Anatomic Pathology & Clinical Pathology Physician	$405.8K	$0
Christopher Scott	VA	Dermatology Physician	$250.5K	$0
Wegmans Food Markets, Inc.	VA	Pharmacy	$198.7K	$0
Emily Christman	VA	Gastroenterology Physician	$176.5K	$0
Donna Reese	VA	Primary Care Nurse Practitioner	$134.7K	$13.3K

Pediatric Associates Of Charlottesville — Billing Profile & Reimbursement Data

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Pediatric Associates Of Charlottesville — 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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