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

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

Big Horn Basin Childrens Clinic PC (NPI 1629304589)

Big Horn Basin Childrens Clinic PC is a pediatrics physician provider located in Cody, Wyoming. This profile covers 0 Medicare and 33 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	Big Horn Basin Childrens Clinic PC
Address	1220 Sunshine Ave Suite 101
City	Cody
State	WY
ZIP	82414
Taxonomy	Pediatrics Physician
NPI Enumerated	October 28, 2009

Payer Source	Total Paid
Medicaid	$997.5K
Medicare	$0

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

33 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…	5,000	$60	$295.1K
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…	2,940	$90	$249.8K
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.	3,070	$40	$129.1K
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…	1,520	$80	$126.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	910	$80	$75.3K
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…	770	$70	$56.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	230	$90	$21.6K
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,…	310	$40	$11.5K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	400	$20	$8.9K
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…	430	$20	$8.2K

Showing 1–10 of 33

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wyoming Distribution

Big Horn Basin Childrens Clinic PC — 0 of 23 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wyoming

Full comparison — all codes billed, vs. Wyoming median

33 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…	27	220	400	$50	$79.3K
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…	27	260	420	$30	$67.2K
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…	12	50	280	$70	$43.2K
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.	7	70	490	$40	$42.9K
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…	5	40	170	$70	$34.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	4	30	100	$60	$17.8K
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,…	12	20	330	$30	$16.8K
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…	10	30	260	$20	$15.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	29	40	80	$90	$15.7K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	4	30	70	$60	$7.6K

Showing 1–10 of 33

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northern Ddsp, Inc.	WY	Developmentally Disabled Services Day Training Agency	$0	$9.1M
Hands 2 Help, LLC.	WY	Home Health Agency	$0	$2.9M
West Park Hospital District	WY	Critical Access Hospital	$0	$950.8K
Northern Wyoming Surgical Center, LLC	WY	Ambulatory Surgical Clinic/Center	$865.9K	$0
Guardian Flight LLC	WY	Air Ambulance	$738.8K	$0
West Park Hospital District	WY	Multi-Specialty Clinic/Center	$0	$726.1K
Cailyn Dallman	WY	Case Manager/Care Coordinator	$0	$630.7K
Barry Welch	WY	Ophthalmology Physician	$430.2K	$0
Allen Gee	WY	Neurology Physician	$344K	$0
Basin Vision Center, P. C.	WY	Optometrist	$0	$310.1K

Big Horn Basin Childrens Clinic PC — Billing Profile & Reimbursement Data

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Big Horn Basin Childrens Clinic 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

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