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

Why is the Medicaid comparison limited to Tennessee 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. Tennessee (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 Health Care Associates, PC (NPI 1750592689)

Pediatric Health Care Associates, PC is a pediatrics physician provider located in Chattanooga, Tennessee. This profile covers 0 Medicare and 73 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 Health Care Associates, PC
Address	3300 Wilcox Blvd
City	Chattanooga
State	TN
ZIP	37411
Taxonomy	Pediatrics Physician
NPI Enumerated	May 24, 2007

Payer Source	Total Paid
Medicaid	$3.2M
Medicare	$0

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

73 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…	15,620	$40	$624.8K
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.	15,930	$40	$621.4K
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…	6,440	$60	$412K
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…	6,120	$60	$342.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5,380	$60	$338.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	3,970	$70	$270.2K
96160	The provider administers a questionnaire aimed at helping to identify a specific health risk to a patient, analyzes the results, assigns a score, and documents the findings. Use this code for each…	10,310	$20	$206.2K
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…	3,120	$20	$71.6K
96161	The provider administers a questionnaire aimed at helping to identify a specific health risk to a patient's caregiver, analyzes the results, assigns a score, and documents the findings. Use this code…	2,770	$20	$44.3K
85018	The lab analyst measures the hemoglobin in a whole blood sample. Hemoglobin is the red pigmented iron compound contained in the red blood cell that combines with oxygen needed by the body tissue.	16,440	$1	$32.9K

Showing 1–10 of 73

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Pediatric Health Care Associates, PC — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

73 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	63	70	250	$20	$215.6K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	65	70	270	$20	$215.5K
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.	57	610	1,220	$40	$206K
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…	2,168	3,760	610	$40	$202.3K
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…	56	520	470	$70	$187K
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…	258	4,050	620	$30	$183.9K
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…	56	480	580	$60	$174.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	46	510	240	$70	$133.7K
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…	130	620	740	$20	$88.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	34	420	150	$80	$81.8K

Showing 1–10 of 73

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chattanooga Children's Clinic, PLLC	TN	Pediatrics Physician	$0	$8.4M
Me Homecare LLC	TN	In Home Supportive Care Agency	$0	$5.3M
Allied Behavioral Services, Inc.	TN	Behavior Analyst	$0	$4.2M
Eastdale Family Dentistry	TN	Dentist	$0	$3.5M
Memorial Health Partners Foundation, Inc	TN	Internal Medicine Physician	$8.8K	$2.7M
Shimon Oami	TN	Dermatopathology (Pathology) Physician	$490.1K	$720
Charles Kirby	TN	Ophthalmology Physician	$246K	$0
Robert Levy	TN	Ophthalmology Physician	$210.3K	$0
David Huffman	TN	Endocrinology, Diabetes & Metabolism Physician	$192.5K	$0
Harsha Shanthaveerappa	TN	Pulmonary Disease Physician	$118.5K	$0

Pediatric Health Care Associates, PC — Billing Profile & Reimbursement Data

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Pediatric Health Care Associates, 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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