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

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

Pioneer Pediatrics Inc (NPI 1902032220)

Pioneer Pediatrics Inc is a pediatrics physician provider located in Las Vegas, Nevada. This profile covers 0 Medicare and 54 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	Pioneer Pediatrics Inc
Address	4840 E. Bonanza St
City	Las Vegas
State	NV
ZIP	89110
Taxonomy	Pediatrics Physician
NPI Enumerated	June 1, 2009

Payer Source	Total Paid
Medicaid	$3.7M
Medicare	$0

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

54 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…	24,640	$50	$1.3M
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.	15,840	$40	$601.8K
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…	6,050	$70	$447.9K
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…	6,360	$60	$406.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	4,670	$70	$326.6K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1,820	$70	$123.9K
99188	The provider applies a fluoride adhesive over the tooth surface to prevent tooth decay, provide remineralization, or treat hypersensitivity.	12,570	$10	$113.2K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	1,840	$50	$88.1K
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…	1,810	$40	$67.1K
99070	Then provider utilizes items or supplies materials to the patient in excess of what is normally utilized or provided during an encounter. These items might include medical supplies, medications,…	12,720	$1	$50.9K

Showing 1–10 of 54

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nevada Distribution

Pioneer Pediatrics Inc — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nevada

Full comparison — all codes billed, vs. Nevada median

54 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90378	Immunoglobulin is a very complex protein that is produced by certain cells in the body to protect it from various types of infections and produce passive immunity. RSV–IgIM (respiratory syncytial…	3	10	1,070	$1,900	$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…	1,866	2,250	290	$60	$138K
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…	51	2,480	330	$50	$107.6K
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…	15	300	280	$80	$103.8K
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…	15	300	240	$80	$97.1K
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.	14	310	410	$40	$95K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	322	450	470	$40	$92K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	12	270	170	$80	$70.6K
97803	The provider reassesses the dietary needs of a patient and uses specific diet therapy to treat medical conditions and related symptoms by interacting individually with the patient. This code…	7	40	220	$20	$66.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	23	220	130	$80	$57K

Showing 1–10 of 54

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Fresenius Medical Care Ne Las Vegas, LLC	NV	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$7.6M
Rachna Gupta	NV	Ophthalmology Physician	$35.3K	$4.2M
Ferdowsian Global Services PLLC	NV	Clinic/Center	$0	$3.2M
First Dentists LLC	NV	Dentist	$0	$2.1M
Clinica Medica Del Pueblo	NV	Family Medicine Physician	$0	$1.9M
University Medical Center Of Southern Nevada	NV	Urgent Care Clinic/Center	$0	$1.5M
Self Sufficiency Behavioral Health LLC	NV	Community/Behavioral Health Agency	$0	$1.4M
Justo Sataray	NV	Family Medicine Physician	$83.7K	$172.8K
William Derek Richardson	NV	Physical Therapist	$70.7K	$8.9K
Wayne Dunetz	NV	Foot & Ankle Surgery Podiatrist	$53.6K	$5.1K

Pioneer Pediatrics Inc — Billing Profile & Reimbursement Data

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Pioneer Pediatrics Inc — 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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