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.

Pediatric Group Specialists, Ltd. (NPI 1639164833)

Pediatric Group Specialists, Ltd. is a pediatrics physician provider located in Phoenix, Arizona. This profile covers 0 Medicare and 68 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	Pediatric Group Specialists, Ltd.
Address	15650 N Black Canyon Hwy
City	Phoenix
State	AZ
ZIP	85053
Taxonomy	Pediatrics Physician
NPI Enumerated	September 13, 2005

Payer Source	Total Paid
Medicaid	$15.3M
Medicare	$0

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

68 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…	85,590	$50	$4.5M
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.	55,790	$40	$2M
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…	21,870	$80	$1.7M
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…	18,810	$70	$1.4M
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…	16,800	$80	$1.3M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	16,850	$80	$1.3M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	12,640	$80	$1.1M
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	23,480	$30	$727.8K
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.	30,590	$10	$397.7K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	11,870	$30	$344.3K

Showing 1–10 of 68

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

Pediatric Group Specialists, Ltd. — 10 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

68 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	36	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…	183	3,040	750	$50	$343.9K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	79	80	150	$360	$320.3K
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	2,780	600	$50	$267K
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.	11	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…	11	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…	11	300	690	$60	$155.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	9	310	470	$60	$131.9K
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…	347	930	200	$70	$97.7K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	31	80	180	$70	$97.6K

Showing 1–10 of 68

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sage Counseling, Inc.	AZ	Community/Behavioral Health Agency	$0	$40.7M
Touchstone Behavioral Health	AZ	Community/Behavioral Health Agency	$0	$15.3M
Just For Kids Therapy	AZ	Speech-Language Pathologist	$0	$14.6M
Touchstone Behavioral Health	AZ	Community/Behavioral Health Agency	$0	$13.7M
Touchstone Behavioral Health	AZ	Community/Behavioral Health Agency	$0	$13.2M
Prn Medical Services, LLC	AZ	Durable Medical Equipment & Medical Supplies	$804.1K	$11.5M
Apex Recovery Center LLC	AZ	Substance Abuse Rehabilitation Facility	$0	$11.6M
Strength Training Inc	AZ	Physical Therapist	$0	$11.6M
Sima Health Care LLC	AZ	Developmental Disabilities Clinic/Center	$0	$11.4M
Bilingual Slp Services	AZ	Speech-Language Pathologist	$0	$7.6M

Pediatric Group Specialists, Ltd. — Billing Profile & Reimbursement Data

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Pediatric Group Specialists, Ltd. — 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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