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

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

Beacon Pediatrics LLC (NPI 1689959538)

Beacon Pediatrics LLC is a pediatrics physician provider located in Rehoboth Beach, Delaware. This profile covers 0 Medicare and 91 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	Beacon Pediatrics LLC
Address	18947 John J Williams Hwy
City	Rehoboth Beach
State	DE
ZIP	19971
Taxonomy	Pediatrics Physician
NPI Enumerated	October 11, 2011

Payer Source	Total Paid
Medicaid	$3.7M
Medicare	$0

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

91 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…	24,980	$50	$1.1M
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…	6,260	$80	$475.9K
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…	6,140	$60	$380.4K
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…	5,430	$60	$320.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	4,500	$70	$319.7K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,400	$80	$189.5K
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…	2,930	$30	$90.7K
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,…	2,770	$30	$83K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	4,580	$20	$68.7K
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…	4,340	$10	$47.7K

Showing 1–10 of 91

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Delaware Distribution

Beacon Pediatrics LLC — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. Delaware median

91 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	5	10	960	$90	$285.9K
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…	103	500	1,130	$50	$235.1K
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…	4	50	1,070	$70	$226.6K
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…	6	50	1,050	$60	$191.3K
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…	19	540	1,100	$40	$185.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	4	50	800	$70	$170.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	5	50	470	$80	$126.7K
90671	This code represents a vaccine product administered intramuscularly to protect against pneumococcal disease, a bacterial infection. This is a 15–valent vaccine, protecting against 15 strains of the…	2	10	490	$40	$106.2K
99382	The provider performs a well–patient visit for a child who is between the ages of 1 and 4 who meets the definition of new patient.	2	10	1,750	$60	$104.8K
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…	95	190	240	$60	$90.8K

Showing 1–10 of 91

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Coastal Kids Pediatric Dentistry, LLC	DE	Pediatric Dentistry	$0	$9.7M
Ams Of Delaware, LLC	DE	Substance Use Disorder Rehabilitation Hospital Unit	$123.6K	$3.3M
Nouman Asif	DE	Hematology & Oncology Physician	$1.5M	$0
Delaware Eye Surgery Center, LLC	DE	Ambulatory Surgical Clinic/Center	$1.3M	$20.1K
Charles Curry	DE	Ophthalmology Physician	$605.3K	$0
Rehoboth Beach Volunteer Fire Co., Inc.	DE	Ambulance	$459.2K	$62.8K
Scott Fudemberg	DE	Ophthalmology Physician	$353.5K	$0
Arthur Belson	DE	Ophthalmology Physician	$316.3K	$0
Matthew Tulloch	DE	Family Medicine Physician	$257K	$0
Laurie Conti	DE	Optometrist	$203.8K	$44.9K

Beacon Pediatrics LLC — Billing Profile & Reimbursement Data

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Beacon 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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