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

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

Ohio Pediatrics, Inc. (NPI 1619090750)

Ohio Pediatrics, Inc. is a pediatrics physician provider located in Kettering, Ohio. This profile covers 0 Medicare and 55 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	Ohio Pediatrics, Inc.
Address	1775 Delco Park Drive
City	Kettering
State	OH
ZIP	45420
Taxonomy	Pediatrics Physician
NPI Enumerated	April 6, 2007

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.

55 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	45,070	$60	$2.9M
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.	43,090	$30	$1.2M
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…	16,530	$60	$925.4K
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…	19,350	$40	$832K
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…	15,150	$50	$757.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	7,800	$60	$437K
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.	5,830	$10	$70K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1,110	$60	$68.7K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	880	$50	$44K
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…	5,750	$10	$40.2K

Showing 1–10 of 55

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Ohio Distribution

Ohio Pediatrics, Inc. — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

55 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…	107	4,510	500	$60	$377.8K
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…	370	5,080	560	$40	$323.9K
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…	23	430	560	$60	$303.2K
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	480	450	$70	$292.9K
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…	33	270	420	$90	$276K
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…	186	250	710	$110	$209K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	22	480	280	$70	$181.7K
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.	393	700	210	$60	$154.1K
92551	The provider delivers a limited series of tones or sounds to a patient to determine if the patient’s hearing is in an acceptable range to detect hearing problems.	98	290	180	$50	$147.4K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	42	90	140	$70	$145.1K

Showing 1–10 of 55

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Hospice Of Dayton, Inc.	OH	Community Based Hospice Care Agency	$0	$71M
Access Ohio, LLC	OH	Substance Abuse Rehabilitation Facility	$0	$40.1M
Alliance Physicians Inc	OH	Family Medicine Physician	$0	$38.9M
Greater Dayton Surgery Center LLC	OH	Ambulatory Surgical Clinic/Center	$1.1M	$0
Paul Nitz	OH	Orthopaedic Surgery Physician	$196.8K	$0
Jeffrey Hoskins	OH	Orthopaedic Surgery Physician	$137.7K	$0
Kevin Paley	OH	Orthopaedic Surgery Physician	$123.2K	$0
Melissa Rammel	OH	Physician Assistant	$64K	$0
David Seymour	OH	Physical Medicine & Rehabilitation Physician	$44.8K	$0

Ohio Pediatrics, Inc. — Billing Profile & Reimbursement Data

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Ohio Pediatrics, Inc. — 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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