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

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

Children's Doctor, P.C. (NPI 1841287836)

Children's Doctor, P.C. is a pediatrics physician provider located in Phoenix, Arizona. This profile covers 0 Medicare and 50 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	Children's Doctor, P.C.
Address	5720 N 19th Ave
City	Phoenix
State	AZ
ZIP	85015
Taxonomy	Pediatrics Physician
NPI Enumerated	October 4, 2005

Payer Source	Total Paid
Medicaid	$7.5M
Medicare	$0

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

50 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…	54,510	$60	$3M
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.	28,320	$40	$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…	10,880	$80	$891.9K
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…	11,280	$80	$845.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	8,550	$80	$701.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	5,380	$90	$483.8K
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…	2,660	$80	$223.4K
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…	2,650	$30	$66.2K
69210	The provider uses an instrument such as a curette, vacuum evacuation, or forceps to remove entrapped wax from a patient's external auditory canal.	1,060	$40	$44.4K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	1,760	$20	$30K

Showing 1–10 of 50

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Arizona Distribution

Children's Doctor, P.C. — 2 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arizona

Full comparison — all codes billed, vs. Arizona median

50 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	299	400	200	$120	$403K
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…	904	3,040	750	$50	$343.9K
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…	50	2,780	600	$50	$267K
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.	17	420	600	$30	$177K
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…	21	300	860	$50	$165.9K
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…	18	300	690	$60	$155.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	19	310	470	$60	$131.9K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	32	80	180	$70	$97.6K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	22	300	270	$60	$90.1K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	84	230	170	$50	$72.8K

Showing 1–10 of 50

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vhs Of Phoenix Inc	AZ	General Acute Care Hospital	$0	$52.4M
Emergency Group Of Arizona Professional Corporation	AZ	Emergency Medicine Physician	$0	$43.8M
Hope Light Care Recovery Center LLC	AZ	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$28.7M
One Point Psychiatric Services LLC	AZ	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$28M
Open Hearts	AZ	Community/Behavioral Health Agency	$0	$19.9M
Epangelia Properties, LLC	AZ	Family Medicine Physician	$0	$14M
Family Bond Treatment Center LLC	AZ	Community/Behavioral Health Agency	$0	$12.8M
Care Givers Of Arizona, Inc.	AZ	Home Health Registered Nurse	$0	$10.8M
Surgical Specialty Hospital Of Arizona, LLC	AZ	Special Hospital	$0	$10.5M
American Family Medicine LLC	AZ	Family Medicine Physician	$0	$9.5M

Children's Doctor, P.C. — Billing Profile & Reimbursement Data

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Children's Doctor, 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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Frequently Asked Questions

References