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.

Frederick Pediatric Associates P.A. (NPI 1538146717)

Frederick Pediatric Associates P.A. is a pediatrics physician provider located in Frederick, Maryland. This profile covers 0 Medicare and 67 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	Frederick Pediatric Associates P.A.
Address	87 Thomas Johnson Dr
City	Frederick
State	MD
ZIP	21702
Taxonomy	Pediatrics Physician
NPI Enumerated	December 28, 2005

Payer Source	Total Paid
Medicaid	$7.6M
Medicare	$0

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

67 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…	28,280	$90	$2.4M
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…	12,270	$120	$1.5M
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…	7,160	$110	$773.7K
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…	6,690	$100	$675.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	4,500	$110	$486.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,330	$120	$272.5K
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…	5,660	$20	$124.6K
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…	11,660	$10	$116.6K
90648	This code represents a Haemophilus influenzae type b (Hib) vaccine product administered into the muscle to protect against Hib disease. This formulation uses a PRP–T conjugate and follows a four–dose…	5,150	$20	$113.2K
99381	The provider performs a well–baby visit for a child under the age of one.	950	$110	$103K

Showing 1–10 of 67

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

Frederick Pediatric Associates P.A. — 7 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

67 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…	190	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…	66	3,280	610	$80	$296.1K
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…	16	330	800	$110	$228.7K
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…	16	290	730	$100	$212.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	30	350	490	$110	$172.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	50	320	290	$120	$128K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	33	40	460	$80	$103.6K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	83	250	320	$30	$82.2K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	240	870	700	$20	$79.7K
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…	89	120	80	$160	$62K

Showing 1–10 of 67

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Frederick County Public Schools	MD	Local Education Agency (LEA)	$0	$21.3M
Dr.sivakumar Pediatric Dental Center LLC	MD	Pediatric Dentistry	$0	$14.7M
Concerted Care Group Frederick LLC	MD	Methadone Clinic	$290K	$7.4M
Potomac Case Management Services	MD	Case Management Agency	$0	$6.7M
Amr Hegazi	MD	Hematology & Oncology Physician	$2.3M	$0
Grant Louie	MD	Rheumatology Physician	$2.1M	$0
Sadaf Taimur	MD	Hematology & Oncology Physician	$1.7M	$0
Frederick Surgical Center, LLC	MD	Ambulatory Surgical Clinic/Center	$1.7M	$0
Gregory Gagnon	MD	Radiation Oncology Physician	$1.6M	$0
Elhamy Eskander	MD	Medical Oncology Physician	$1.5M	$0

Frederick Pediatric Associates P.A. — Billing Profile & Reimbursement Data

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Frederick Pediatric Associates P.A. — 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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References