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

Why is the Medicaid comparison limited to New York 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. New York (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.

University At Buffalo Pediatric Associates Inc (NPI 1912928599)

University At Buffalo Pediatric Associates Inc is a pediatrics physician provider located in Buffalo, New York. This profile covers 0 Medicare and 64 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	University At Buffalo Pediatric Associates Inc
Address	1001 Main St Fl 4
City	Buffalo
State	NY
ZIP	14203
Taxonomy	Pediatrics Physician
NPI Enumerated	July 21, 2006

Payer Source	Total Paid
Medicaid	$29.1M
Medicare	$0

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

64 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	85,560	$110	$9.2M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	19,290	$160	$3.1M
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…	27,360	$100	$2.7M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	45,950	$60	$2.6M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	4,800	$370	$1.8M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	11,840	$120	$1.4M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	2,580	$380	$977.1K
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	8,040	$110	$892.9K
99204	The provider sees a new 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 provider…	5,290	$150	$777.5K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	10,700	$70	$695.6K

Showing 1–10 of 64

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New York Distribution

University At Buffalo Pediatric Associates Inc — 15 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New York

Full comparison — all codes billed, vs. New York median

64 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	1	10	1,530	$400	$755.8K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	52	1,420	90	$130	$715.2K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	51	450	370	$170	$674.1K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	15	2,210	80	$130	$473K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	278	610	310	$380	$397.9K
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	6	40	90	$380	$367K
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…	1,501	19,110	360	$70	$321K
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	24	90	190	$150	$260.8K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	49	2,330	100	$140	$254.7K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	63	150	110	$520	$248.5K

Showing 1–10 of 64

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Joseph Orie	NY	Pediatric Cardiology Physician	$15.2K	$173.7K
Fred Lewis	NY	Allergy & Immunology Physician	$78.8K	$62.3K
Gary Wang	NY	Physical Medicine & Rehabilitation Physician	$20.3K	$8.4K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kaleida Health	NY	General Acute Care Hospital	$0	$80.7M
Kaleida Health	NY	General Acute Care Hospital	$0	$30.9M
Kaleida Health	NY	General Acute Care Hospital	$0	$22M
Nagaraja Sridhar	NY	Nephrology Physician	$225K	$107.4K
Ashish Bhatia	NY	Clinical Cardiac Electrophysiology Physician	$290.5K	$690
Omniseq, Inc.	NY	Clinical Medical Laboratory	$212K	$0
Romesh Kohli	NY	Nephrology Physician	$127.9K	$4.2K
Avinash Reddy	NY	Urology Physician	$78.8K	$11.7K
Mohammad Ashraf	NY	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$74.2K	$0
Jason Davies	NY	Neurological Surgery Physician	$68.1K	$4K

University At Buffalo Pediatric Associates 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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