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

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

Thrive Pediatrics, LLC (NPI 1669934220)

Thrive Pediatrics, LLC is a pediatrics physician provider located in Meridian, Idaho. This profile covers 0 Medicare and 25 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	Thrive Pediatrics, LLC
Address	4740 N Penngrove Way
City	Meridian
State	ID
ZIP	83646
Taxonomy	Pediatrics Physician
NPI Enumerated	April 3, 2019

Payer Source	Total Paid
Medicaid	$869.3K
Medicare	$0

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

25 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…	3,990	$60	$251.1K
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…	2,540	$90	$228.6K
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…	1,620	$80	$134.3K
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…	1,100	$100	$105.4K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	2,740	$20	$46.6K
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.	1,040	$40	$43.6K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	2,140	$10	$27.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	150	$90	$13K
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…	290	$40	$10K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	550	$10	$2.8K

Showing 1–10 of 25

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Idaho Distribution

Thrive Pediatrics, LLC — 0 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

25 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	137	670	740	$40	$193.6K
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…	145	620	560	$60	$191.8K
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…	29	80	450	$80	$171.3K
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…	28	80	380	$70	$151.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	36	80	130	$80	$91.4K
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.	27	80	460	$30	$77.7K
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…	191	220	90	$80	$51.4K
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…	30	60	290	$30	$48.7K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	17	70	240	$20	$34.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	27	180	140	$10	$28.4K

Showing 1–10 of 25

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
A New Leaf, Inc.	ID	Developmentally Disabled Services Day Training Agency	$0	$29.5M
Southern Idaho Surgery Center PLLC	ID	Ambulatory Surgical Clinic/Center	$0	$5.3M
A Helping Hand In Home Care	ID	In Home Supportive Care Agency	$0	$3.6M
Dental Care For Kids	ID	Pediatric Dentistry	$0	$3.1M
Watchdog LLC	ID	Emergency Response System Companies	$0	$2.4M
Idaho Transition Care, LLC	ID	Case Management Agency	$0	$2.1M
Small Talk Speech & Language Services	ID	Speech-Language Pathologist	$0	$1.8M
D&g Medical Associates PLLC	ID	Family Medicine Physician	$0	$1.3M
Capitol Healthcare, Inc.	ID	In Home Supportive Care Agency	$0	$1.3M
Mountain Pine Dermatology, PLLC	ID	Dermatology Physician	$0	$1.2M

Thrive Pediatrics, LLC — Billing Profile & Reimbursement Data

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Thrive Pediatrics, LLC — 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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