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

Why is the Medicaid comparison limited to Connecticut 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. Connecticut (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 Practice Associates, P.C. (NPI 1831386317)

Pediatric Practice Associates, P.C. is a pediatric adolescent medicine physician provider located in Stamford, Connecticut. This profile covers 0 Medicare and 67 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 Practice Associates, P.C.
Address	1515 Summer St
City	Stamford
State	CT
ZIP	06905
Taxonomy	Pediatric Adolescent Medicine Physician
NPI Enumerated	September 28, 2007

Payer Source	Total Paid
Medicaid	$7.4M
Medicare	$0

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

67 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…	28,540	$70	$2M
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…	8,420	$100	$858.6K
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…	5,040	$120	$600.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5,380	$110	$570.7K
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.	11,550	$40	$485.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	4,150	$110	$460.4K
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…	4,050	$100	$417.3K
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,…	9,830	$40	$403.1K
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.	11,010	$20	$231.3K
99177	The provider uses instruments to conduct a vision screening exam to analyze both eyes to diagnose ocular or eye–related diseases. Both the screening and analysis take place on–site.	11,320	$20	$215K

Showing 1–10 of 67

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Connecticut Distribution

Pediatric Practice Associates, P.C. — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Connecticut

Full comparison — all codes billed, vs. Connecticut median

67 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…	193	1,590	740	$50	$331.8K
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…	84	1,710	750	$30	$243.3K
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…	28	170	850	$80	$203.5K
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…	27	160	680	$70	$166.1K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	71	140	780	$40	$163.2K
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.	36	240	1,560	$20	$159.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	18	180	710	$70	$151.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	13	170	410	$70	$98K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	89	300	300	$20	$61.6K
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…	23	140	1,300	$10	$51.7K

Showing 1–10 of 67

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dental Care Kids	CT	Pediatric Dentistry	$0	$9.7M
Center For Vein Restoration Ct LLC	CT	Vascular Surgery Physician	$0	$7.9M
Summer Pediatrics LLC	CT	Pediatrics Physician	$0	$7.4M
Cornerstone Pediatrics	CT	Pediatrics Physician	$0	$3.4M
All Ages Medical Care Inc	CT	Pediatrics Physician	$0	$3M
Stamford Eye Care PC	CT	Optometrist	$0	$2.9M
Lifestyle Medicine Center LLC	CT	Pediatrics Physician	$0	$2.6M
Stamford Pediatric Associates, P.C.	CT	Pediatrics Physician	$0	$2.2M
Stamford Uc PC	CT	Family Medicine Physician	$0	$1.8M
Alejandra Hochstedler-stipo	CT	Professional Counselor	$0	$1.7M

Pediatric Practice Associates, P.C. — Billing Profile & Reimbursement Data

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Pediatric Practice Associates, P.C. — 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