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

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

Kids.healthcare PC (NPI 1821459413)

Kids.healthcare PC is a pediatrics physician provider located in Fort Wayne, Indiana. This profile covers 0 Medicare and 75 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	Kids.healthcare PC
Address	2510 E Dupont Rd
City	Fort Wayne
State	IN
ZIP	46825
Taxonomy	Pediatrics Physician
NPI Enumerated	March 10, 2016

Payer Source	Total Paid
Medicaid	$4.8M
Medicare	$0

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

75 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…	25,150	$60	$1.5M
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…	13,120	$80	$1.1M
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…	5,140	$80	$431.9K
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…	4,820	$80	$385.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	3,440	$80	$289K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	5,230	$30	$151.5K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	7,590	$20	$144.2K
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.	8,430	$20	$126.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1,120	$90	$97.4K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	8,730	$10	$78.6K

Showing 1–10 of 75

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Indiana Distribution

Kids.healthcare PC — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. Indiana median

75 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	218	2,120	870	$60	$450.6K
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…	591	690	1,070	$80	$422.3K
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…	159	2,380	920	$50	$376.8K
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…	51	280	880	$80	$267.2K
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…	47	290	770	$80	$250.8K
94761	The provider takes multiple measurements of the patient’s oxygen saturation using a sensor on the ear or finger.	12	20	270	$50	$187K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	197	270	470	$30	$171.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	47	320	310	$80	$133.9K
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…	260	510	180	$90	$93.6K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	57	390	990	$20	$74.5K

Showing 1–10 of 75

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
A.i.d. Residential Services, LLC	IN	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$16.4M
Familia Dental Fort Wayne PLLC	IN	Dental Clinic/Center	$0	$8.7M
Lakewood Family Dental Inc	IN	Dentist	$0	$8.7M
Associated Surgeons And Physicians, LLC	IN	Obstetrics & Gynecology Physician	$0	$8.5M
Orthopaedics Northeast PC	IN	Orthopaedic Surgery Physician	$0	$6.6M
Hand In Hand Comprehensive Therapy Specialists Inc	IN	Occupational Therapist	$0	$6.4M
Steppin Up Physical Therapy, Inc.	IN	Physical Therapist	$0	$4.6M
Mobile Medical Maintenance, LLC	IN	Durable Medical Equipment & Medical Supplies	$0	$4.3M
Dupont Hospital LLC	IN	General Acute Care Hospital	$0	$3.8M
Ear, Nose & Throat Associates, PC	IN	Otolaryngology Physician	$0	$3.4M

Kids.healthcare PC — Billing Profile & Reimbursement Data

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Kids.healthcare 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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