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.

Cactus Childrens Clinic PC (NPI 1891850145)

Cactus Childrens Clinic PC is a pediatrics physician provider located in Glendale, Arizona. This profile covers 0 Medicare and 44 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	Cactus Childrens Clinic PC
Address	5940 W Union Hills Dr
City	Glendale
State	AZ
ZIP	85308
Taxonomy	Pediatrics Physician
NPI Enumerated	December 27, 2006

Payer Source	Total Paid
Medicaid	$6M
Medicare	$0

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

44 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…	40,990	$50	$2M
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.	25,240	$50	$1.2M
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…	10,650	$80	$809.6K
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…	9,240	$70	$674.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	8,050	$70	$571.7K
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…	3,210	$80	$240.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,720	$70	$201.3K
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…	1,600	$40	$67.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	2,920	$20	$43.8K
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…	1,820	$20	$41.9K

Showing 1–10 of 44

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

Cactus Childrens Clinic PC — 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

44 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…	825	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…	82	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.	21	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…	25	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…	20	300	690	$60	$155.9K
A7005	Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable	14	20	30	$20	$152K
99203	The provider sees a new 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 provider…	942	1,030	130	$70	$134.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	22	310	470	$60	$131.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	48	300	270	$60	$90.1K
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,…	259	850	230	$40	$72.5K

Showing 1–10 of 44

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vhs Of Arrowhead, Inc	AZ	General Acute Care Hospital	$0	$27.7M
Family Care Connections LLC	AZ	Home Health Agency	$0	$23.7M
Arizona Spine And Pain Specialists LLC	AZ	Interventional Pain Medicine Physician	$0	$14.1M
Am Nutrition Services	AZ	Registered Dietitian	$0	$12.8M
El Bondy Medical Transportation LLC	AZ	Non-emergency Medical Transport (VAN)	$0	$9.3M
Brian S Page Do LLC	AZ	Pain Medicine Physician	$0	$9.1M
Raymond W Lemberg Phd PC	AZ	Psychologist	$0	$7.5M
Southwest Kidney Davita Dialysis Partners LLC	AZ	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$6M
Surgery Center Of Scottsdale LLC	AZ	Ambulatory Surgical Clinic/Center	$1M	$3.5M
Arrowhead Endoscopy And Pain Management Center LLC	AZ	Ambulatory Surgical Clinic/Center	$337.8K	$2.6M

Cactus Childrens Clinic PC — Billing Profile & Reimbursement Data

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Cactus Childrens Clinic 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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