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

Why is the Medicaid comparison limited to Washington 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. Washington (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 Associates Of Whidbey Island, Ps (NPI 1770700072)

Pediatric Associates Of Whidbey Island, Ps is a pediatrics physician provider located in Oak Harbor, Washington. This profile covers 0 Medicare and 47 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 Associates Of Whidbey Island, Ps
Address	275 Se Cabot Dr
City	Oak Harbor
State	WA
ZIP	98277
Taxonomy	Pediatrics Physician
NPI Enumerated	April 19, 2007

Payer Source	Total Paid
Medicaid	$5M
Medicare	$0

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

47 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	40,880	$70	$2.7M
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…	16,310	$60	$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…	7,980	$90	$694.1K
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…	1,980	$90	$170K
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…	1,480	$80	$119.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,160	$90	$98.5K
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…	4,480	$10	$49.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	280	$90	$25.9K
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.	5,240	$1	$21K
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,…	230	$40	$8.4K

Showing 1–10 of 47

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Washington Distribution

Pediatric Associates Of Whidbey Island, Ps — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. Washington median

47 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	81	650	4,110	$250	$4.9M
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…	233	1,820	480	$60	$379.6K
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…	160	1,860	610	$40	$295.5K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	778	930	680	$60	$259.2K
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…	85	280	540	$70	$166.5K
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…	74	300	400	$80	$164.4K
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…	332	540	130	$90	$128.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	83	320	290	$70	$104.8K
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,…	310	700	180	$50	$59.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	95	280	110	$70	$45.2K

Showing 1–10 of 47

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
L.e.a.p.s And Beyond, Inc	WA	Community/Behavioral Health Agency	$0	$6.5M
Preferred Podiatry Group PC	WA	Podiatrist	$0	$4.7M
Sea Mar Community Health Centers	WA	Federally Qualified Health Center (FQHC)	$0	$3.1M
Whidbey Island Public Hospital District	WA	Rural Health Clinic/Center	$0	$3M
Whidbey Island Public Hospital District	WA	Rural Health Clinic/Center	$0	$2.7M
Reese Bliek	WA	Medical Physician Assistant	$508.7K	$0
Robert Johnson	WA	Ophthalmology Physician	$365.8K	$0
Walgreen Co	WA	Pharmacy	$175.8K	$400
Robert Lycksell	WA	Family Medicine Physician	$152.3K	$0
Soas, LLC	WA	Pharmacy	$70.1K	$1.2K

Pediatric Associates Of Whidbey Island, Ps — Billing Profile & Reimbursement Data

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Pediatric Associates Of Whidbey Island, Ps — 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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References