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

Why is the Medicaid comparison limited to Florida 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. Florida (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 Physician Services, Inc. (NPI 1770532798)

Key Findings

Field	Value
Entity Type	Organization
Organization	Pediatric Physician Services, Inc.
Address	501 6th Ave S
City	St Petersburg
State	FL
ZIP	33701
Taxonomy	Pediatrics Physician
NPI Enumerated	May 8, 2006

Payer Source	Total Paid
Medicaid	$43.4M
Medicare	$0

This provider reports no Medicare billing on file and $43.4M in total Medicaid revenue, meaning its entire documented payer volume is effectively Medicaid-driven. The absence of Medicare activity makes PEDIATRIC PHYSICIAN SERVICES, INC. a single‑payer (Medicaid) billing entity in the available data, concentrating all reimbursement exposure on state Medicaid policy and contracts.

The top 3 Medicaid codes by revenue account for 44.1% of this provider's total Medicaid revenue, showing meaningful revenue concentration in a small set of services. Those three codes are 99284 ($9.1M, 23.8%), 99214 ($4.9M, 12.9%), and 99285 ($2.8M, 7.4%), which together drive a large share of reported collections and therefore disproportionately shape the provider's financial profile.

The code mix — dominated by 99284 (117.6K claims), 99285 (20.7K claims), and high-volume office E/M codes such as 99214 (70K claims) and 99215 (28.4K claims) — indicates an operation that combines emergency department throughput with substantial ambulatory/established-patient practice. High counts for both ED-level E/M and office-level E/M suggest the organization runs or staffs high-volume urgent/emergency pediatric services alongside routine and complex outpatient visits.

Several specialized diagnostic codes appear at state-leading volumes, signaling embedded procedural capacity beyond general pediatrics. Echocardiography codes 93303 ($1.5M) and 93306 ($1.1M) rank #1 of 93 (100th percentile, extreme outlier) and #10 of 681 (99th percentile, extreme outlier) respectively, and MRI brain 70551 ($655.8K) ranks #3 of 145 (99th percentile), together suggesting significant pediatric cardiac imaging and advanced diagnostic capability within the practice.

On competitive standing, the provider is a dominant statewide participant for several high-revenue pediatric E/M and imaging codes. For example, 99214 ranks #21 of 6379 providers in-state (100th percentile; extreme outlier) and 99215 ranks #2 of 979 providers in-state (100th percentile; extreme outlier), while 99284 ranks #14 of 739 (98th percentile; notably above typical state volume), which collectively indicates market leadership in select service lines.

The broader procedure mix shows both very high-volume, low-unit-reimbursement services and mid-to-high acuity care, reflecting operational breadth. Routine diagnostics and monitoring appear in large volume — 71045 (67.7K claims, $406.2K) and 93010 (50.8K claims, $508.3K) — alongside critical care (99291, $869.4K) and inpatient subsequent care (99232, $2.6M; 99233, $1.9M), implying the organization manages high patient throughput and provides inpatient/critical services as well as outpatient and ED care.

The provider has an established billing history, with NPI enumeration dated 2006-05-08 (~20 years ago), suggesting long tenure in the market. Combined with the extreme outlier rankings on multiple codes and sustained high claim volumes, the data indicate a stable, long-standing presence in Florida's pediatric Medicaid delivery system rather than a recent entrant.

Because top codes concentrate 44.1% of Medicaid revenue and there is no Medicare revenue to diversify payer exposure, the provider's Medicaid-focused revenue stream could be sensitive to shifts in Medicaid reimbursement, utilization patterns, or coding guidance for those high-impact codes. This concentration highlights potential operational sensitivity — changes affecting 99284, 99214, or 99285 would materially alter revenue given their outsized shares.

Medicaid: Complete Services Breakdown

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

301 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	117,630	$80	$9.1M
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…	70,040	$70	$4.9M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	20,700	$140	$2.8M
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…	28,410	$100	$2.8M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	35,770	$70	$2.6M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	39,320	$70	$2.6M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	19,750	$100	$1.9M
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	18,950	$80	$1.5M
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…	31,880	$40	$1.4M
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	15,030	$70	$1.1M

Showing 1–10 of 301

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Florida Distribution

Pediatric Physician Services, Inc. — 14 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Florida

Full comparison — all codes billed, vs. Florida median

301 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	25	30	2,220	$350	$1.3M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	89	700	2,400	$80	$1.2M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	14	740	2,180	$70	$1.1M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	79	660	1,900	$70	$743.6K
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	8	30	310	$720	$616.3K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	14	320	1,970	$90	$463.1K
86003	The lab analyst performs the technical lab test to analyze a specimen such as serum for allergen–specific immunoglobulin E (IgE), using a crude allergen extract. The test result is quantitative or…	7	20	620	$30	$423.4K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	293	350	1,160	$80	$308.7K
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	1	90	320	$180	$307.9K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	3	80	150	$440	$271.5K

Showing 1–10 of 301

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
West Coast Neonatology, Inc.	FL	Neonatal-Perinatal Medicine Physician	$0	$18.8M
Amit Sharma	TX	Vascular & Interventional Radiology Physician	$469.7K	$0
Wesley Pruett	MN	Diagnostic Radiology Physician	$441.3K	$770
Joshua Albrektson	MN	Diagnostic Radiology Physician	$264.9K	$2K
Krishna Iyer	MN	Vascular & Interventional Radiology Physician	$248K	$0
Scott Sullivan	CT	Diagnostic Radiology Physician	$219K	$0
Kimberly Jordan	MN	Diagnostic Radiology Physician	$215.2K	$0
Joseph Rozell	MN	Diagnostic Radiology Physician	$208K	$70
Erasmo Passaro	FL	Neurology Physician	$195.1K	$0
Orhan Konez	FL	Diagnostic Radiology Physician	$181.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Johns Hopkins All Children's Hospital, Inc	FL	Children's Hospital	$0	$152.9M
Access Home Health Care Inc	FL	Home Health Agency	$0	$15.1M
Pediatric Gastroenterology Hepatology & Nutrition Of Fl P A	FL	Pediatric Gastroenterology Physician	$0	$14.9M
Rai Care Centers Of St. Petersburg, LLC	FL	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$11.3M
Pediatric Otolaryngology Head And Neck Surgeyr Assoc. PA	FL	Specialist	$0	$11.2M
Ohi West, Inc	FL	Rehabilitation Hospital Unit	$0	$10.3M
St Petersburg Kidney Care LLC	FL	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$9.9M
Fresenius Kidney Care American Dialysis, LLC	FL	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$8.5M
Children's Orthopaedic & Scoliosis Surgery Associates, LLP	FL	Pediatric Orthopaedic Surgery Physician	$0	$7.3M
John Peterson	FL	Medical Oncology Physician	$1.3M	$0

Pediatric Physician Services, Inc. — Billing Profile & Reimbursement Data

Sign up for Pediatric Physician Services, Inc. — Billing Profile & Reimbursement Data policy alerts

Pediatric Physician Services, Inc. — Billing Profile & Reimbursement Data

Sign up for Pediatric Physician Services, Inc. — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References