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

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

Lowry Pediatrics, PC (NPI 1912133356)

Lowry Pediatrics, PC is a pediatrics physician provider located in Denver, Colorado. This profile covers 0 Medicare and 84 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	Lowry Pediatrics, PC
Address	8101 E Lowry Blvd Ste 260
City	Denver
State	CO
ZIP	80230
Taxonomy	Pediatrics Physician
NPI Enumerated	May 29, 2009

Payer Source	Total Paid
Medicaid	$4.4M
Medicare	$0

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

84 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	12,930	$90	$1.2M
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…	6,090	$90	$517.4K
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…	5,080	$90	$462.5K
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…	5,140	$70	$334K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	3,130	$90	$284.4K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	11,710	$20	$210.8K
H0025	Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior)	1,410	$140	$191.4K
92587	Code 92587 is in the Medicine/Special Otorhinolaryngologic Services Section. It involves special procedures of the ears/nose/throat. This code is for screening purposes with interpretation and…	5,390	$40	$188.6K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1,470	$100	$145K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	6,820	$20	$122.7K

Showing 1–10 of 84

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Lowry Pediatrics, PC — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

84 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	325	2,520	330	$100	$352K
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…	143	2,630	430	$90	$268.2K
H0025	Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior)	27	100	320	$80	$229.2K
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…	20	240	550	$110	$208.5K
H0023	Alcohol and/or drug outreach	123	190	360	$60	$163.1K
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	260	380	$100	$161.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	27	290	160	$110	$111.1K
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…	238	720	130	$100	$110K
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.	81	330	530	$30	$100.6K
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…	64	280	510	$30	$77.4K

Showing 1–10 of 84

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Denver Health And Hospital Authority	CO	Federally Qualified Health Center (FQHC)	$0	$25.5M
Total Longterm Care, Inc.	CO	Exclusive Provider Organization	$0	$13M
Denver Health And Hospital Authority	CO	Federally Qualified Health Center (FQHC)	$0	$8.3M
Miriah Teeter	CO	Retina Specialist (Ophthalmology) Physician	$1.9M	$0
Nancy Christmas	CO	Retina Specialist (Ophthalmology) Physician	$1.8M	$0
David Johnson	CO	Specialist	$1.5M	$0
Stephen Murphy	CO	Rheumatology Physician	$1.4M	$0
Gregory Barron	CO	Rheumatology Physician	$1.4M	$0
Brian Joondeph	CO	Retina Specialist (Ophthalmology) Physician	$1.4M	$0
Rennie Mccabe	CO	Rheumatology Physician	$1.3M	$0

Lowry Pediatrics, PC — Billing Profile & Reimbursement Data

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Lowry Pediatrics, 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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