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

Why is the Medicaid comparison limited to Iowa 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. Iowa (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 & Adult Allergy PC (NPI 1609932201)

Field	Value
Entity Type	Organization
Organization	Pediatric & Adult Allergy PC
Address	1212 Pleasant St
City	Des Moines
State	IA
ZIP	50309
Taxonomy	Allergy Physician
NPI Enumerated	December 28, 2006

Payer Source	Total Paid
Medicaid	$1.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	2,180	$160	$347.3K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	2,650	$110	$285.9K
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…	2,660	$90	$231.7K
95117	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives 2 or more injections at a single visit.	12,920	$20	$206.7K
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…	1,550	$50	$75.7K
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…	2,250	$30	$74.2K
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…	520	$20	$10.9K
95115	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives a single injection during the visit.	40	$10	$510
94640	The provider administers oxygen under pressure or not under pressure to open obstructed air passages. He uses any of the listed devices to treat a patient with an acute obstruction of the airway that…	10	$10	$100

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Iowa Distribution

Pediatric & Adult Allergy PC — 2 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Iowa

Full comparison — all codes billed, vs. Iowa median

9 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…	343	1,060	480	$40	$154.5K
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…	428	1,310	760	$20	$153.1K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	3	20	510	$110	$112.1K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	2	30	410	$120	$79.2K
95117	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives 2 or more injections at a single visit.	3	30	1,150	$10	$52.3K
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…	12	250	110	$80	$47.1K
95115	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives a single injection during the visit.	6	10	260	$10	$34.2K
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…	11	30	400	$10	$13.7K
94640	The provider administers oxygen under pressure or not under pressure to open obstructed air passages. He uses any of the listed devices to treat a patient with an acute obstruction of the airway that…	50	60	70	$10	$1.3K

Nearby Providers

Other providers in the same ZIP code as Pediatric & Adult Allergy PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Central Iowa Hospital Corporation	IA	General Acute Care Hospital	$0	$58M
Eyerly Ball Community Mental Health Services	IA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$57M
City Of Des Moines Iowa	IA	Land Ambulance	$1.1M	$47.2M
Orchard Place	IA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$30.5M
Woodward Youth Corporation	IA	Community/Behavioral Health Agency	$0	$28.2M
Dhs-targeted Case Management	IA	Case Management Agency	$0	$26.2M
Central Iowa Hospital Corporation	IA	Pediatrics Physician	$0	$25.4M
Central Iowa Hospital Corporation	IA	Emergency Medicine Physician	$0	$13.1M
Orchard Place	IA	Adolescent and Children Mental Health Clinic/Center	$0	$6.6M
Robert Behrens	IA	Medical Oncology Physician	$5.2M	$0

Pediatric & Adult Allergy PC — Billing Profile & Reimbursement Data

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Pediatric & Adult Allergy PC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References