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

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

Scottsdale Pediatrics And Pediatric Nephrology, PLLC (NPI 1629076518)

Scottsdale Pediatrics And Pediatric Nephrology, PLLC is a pediatrics physician provider located in Phoenix, Arizona. This profile covers 0 Medicare and 56 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	Scottsdale Pediatrics And Pediatric Nephrology, PLLC
Address	7010 E Chauncey Ln Ste 225
City	Phoenix
State	AZ
ZIP	85054
Taxonomy	Pediatrics Physician
NPI Enumerated	July 13, 2005

Payer Source	Total Paid
Medicaid	$10.5M
Medicare	$0

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

56 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…	37,050	$70	$2.6M
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…	43,210	$50	$2.2M
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.	33,700	$30	$1.1M
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…	14,220	$70	$995.2K
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…	13,290	$70	$983.5K
41115	In this procedure, the provider makes an incision at the base of the tongue and excises the frenum.	3,630	$220	$805.9K
40819	In this procedure, the provider removes the labial or buccal frenum, each of which is a membrane structure in the mouth. Labial refers to the lip and buccal refers to the cheek.	1,800	$260	$467K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5,680	$70	$414.9K
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…	2,230	$110	$242.5K
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…	8,780	$20	$210.8K

Showing 1–10 of 56

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Arizona Distribution

Scottsdale Pediatrics And Pediatric Nephrology, PLLC — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arizona

Full comparison — all codes billed, vs. Arizona median

56 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
41115	In this procedure, the provider makes an incision at the base of the tongue and excises the frenum.	1	10	1,850	$220	$406.9K
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.	372	400	200	$120	$403K
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…	105	3,040	750	$50	$343.9K
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…	75	2,780	600	$50	$267K
92587	Code 92587 is in the Medicine/Special Otorhinolaryngologic Services Section. It involves special procedures of the ears/nose/throat. This code is for screening purposes with interpretation and…	16	40	390	$140	$264.4K
40819	In this procedure, the provider removes the labial or buccal frenum, each of which is a membrane structure in the mouth. Labial refers to the lip and buccal refers to the cheek.	1	10	980	$250	$250.5K
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.	15	420	600	$30	$177K
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…	18	300	860	$50	$165.9K
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…	15	300	690	$60	$155.9K
99203	The provider sees a new 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 provider…	604	1,030	130	$70	$134.1K

Showing 1–10 of 56

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mayo Clinic Arizona	AZ	General Acute Care Hospital	$0	$12.5M
Steve Huang	AZ	Nuclear Medicine Physician	$1.4M	$0
Talal Hilal	AZ	Hematology & Oncology Physician	$1.2M	$0
Premal Desai	AZ	Urology Physician	$926.2K	$0
Mahesh Seetharam	AZ	Hematology & Oncology Physician	$733.7K	$0
Joshua Duncan	AZ	Ophthalmology Physician	$540.5K	$0
Jonathan Levin	AZ	Ophthalmology Physician	$442.6K	$0
Brad Bruns	AZ	Orthopaedic Surgery Physician	$379.2K	$0
Philip To	AZ	Orthopaedic Hand Surgery Physician	$288.1K	$0
Stephen Finberg	AZ	Pulmonary Disease Physician	$278.7K	$0

Scottsdale Pediatrics And Pediatric Nephrology, PLLC — 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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