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

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

Montgomery Pediatric Assoc, P.A. (NPI 1770532681)

Montgomery Pediatric Assoc, P.A. is a pediatric adolescent medicine physician provider located in Montgomery, Alabama. This profile covers 0 Medicare and 57 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	Montgomery Pediatric Assoc, P.A.
Address	420 Cotton Gin Rd
City	Montgomery
State	AL
ZIP	36117
Taxonomy	Pediatric Adolescent Medicine Physician
NPI Enumerated	May 8, 2006

Payer Source	Total Paid
Medicaid	$8.3M
Medicare	$0

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

57 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…	64,990	$40	$2.9M
T1015	Clinic visit/encounter, all-inclusive	19,570	$100	$1.9M
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…	14,060	$50	$660.8K
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…	13,940	$50	$655.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	7,440	$50	$371.8K
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…	4,560	$70	$300.9K
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.	11,540	$20	$207.7K
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	8,960	$20	$161.3K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	14,660	$10	$132K
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.	11,990	$10	$131.9K

Showing 1–10 of 57

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alabama Distribution

Montgomery Pediatric Assoc, P.A. — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. Alabama median

57 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	76	240	6,820	$120	$2.9M
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	85	100	470	$130	$1.2M
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	43	90	500	$40	$303.6K
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…	344	1,990	680	$60	$201.7K
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…	121	330	140	$240	$197.4K
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…	16	1,990	560	$40	$185.6K
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…	8	270	1,360	$60	$159.7K
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…	10	300	1,160	$50	$147.8K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	50	110	610	$40	$143.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	14	320	640	$50	$98.1K

Showing 1–10 of 57

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Health Care Authority For Baptist Health An Affiliate Of Uabhs	AL	General Acute Care Hospital	$0	$12M
Tooth Buds At Lagoon Park, LLC	AL	General Practice Dentistry	$0	$7.8M
Health Care Authority For Baptist Health, An Affiliate Of Uabhs	AL	Internal Medicine Physician	$0	$7.5M
Smiles From Us, PLLC	AL	Pediatric Dentistry	$0	$5.9M
Dentists 4 Children, L.L.C.	AL	Pediatric Dentistry	$0	$5.7M
Pediatric Specialists Of Montgomery, L.L.C.	AL	Pediatric Cardiology Physician	$0	$5.3M
Alexander Pediatrics LLC	AL	Pediatrics Physician	$0	$4.8M
River Region Psychiatry Associates LLC	AL	Psychiatry Physician	$0	$4.5M
Oral And Maxillofacial Surgery Associates	AL	Oral and Maxillofacial Surgery (Dentist)	$0	$4.4M
East Montgomery Pediatrics LLC	AL	Pediatrics Physician	$0	$3M

Montgomery Pediatric Assoc, P.A. — Billing Profile & Reimbursement Data

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Montgomery Pediatric Assoc, P.A. — 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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