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

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

Burlington Pediatric Association, P.C. (NPI 1942294244)

Burlington Pediatric Association, P.C. is a pediatrics physician provider located in West Burlington, Iowa. This profile covers 0 Medicare and 41 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	Burlington Pediatric Association, P.C.
Address	1223 S Gear Ave
City	West Burlington
State	IA
ZIP	52655
Taxonomy	Pediatrics Physician
NPI Enumerated	September 1, 2005

Payer Source	Total Paid
Medicaid	$1.8M
Medicare	$0

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

41 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…	20,480	$40	$737.4K
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…	3,400	$70	$231.1K
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…	2,410	$70	$178.4K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	3,720	$40	$141.2K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	1,590	$90	$136.5K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	4,370	$20	$91.7K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	6,810	$10	$74.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	410	$80	$32.8K
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…	500	$60	$28.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	320	$80	$24.4K

Showing 1–10 of 41

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Iowa Distribution

Burlington Pediatric Association, P.C. — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Iowa

Full comparison — all codes billed, vs. Iowa median

41 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…	526	1,060	480	$40	$154.5K
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…	85	1,310	760	$20	$153.1K
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…	28	170	540	$50	$101.2K
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…	30	190	300	$50	$91.7K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	66	180	220	$40	$56.6K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	14	170	190	$40	$53.4K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	13	130	120	$80	$52.1K
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…	42	80	190	$40	$41.5K
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…	64	170	170	$40	$40.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	75	250	110	$50	$39.9K

Showing 1–10 of 41

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Health Centers Of Southeastern Iowa Inc	IA	Federally Qualified Health Center (FQHC)	$0	$35.3M
Southeast Iowa Regional Medical Center, Inc.	IA	General Acute Care Hospital	$0	$21.2M
Southeast Iowa Regional Medical Center, Inc.	IA	General Practice Physician	$0	$12.3M
Community Health Center Of Seia, Inc	IA	Dentist	$0	$3.7M
Burlington Neurology And Sleep Clinic, Plc	IA	Neurology Physician	$0	$1.2M
Burlington Ear Nose & Throat Clinic PC	IA	Otolaryngology Physician	$0	$907.7K
Aneesh Neekhra	IA	Neurology Physician	$210.9K	$234.4K
Douglas Henrich	IA	Otolaryngology Physician	$198.1K	$101.9K
Michael Abouassaly	IA	Family Medicine Physician	$275K	$0
Eric O'brien	IA	Optometrist	$45.6K	$204.5K

Burlington Pediatric Association, P.C. — Billing Profile & Reimbursement Data

Sign up for Burlington Pediatric Association, P.C. — Billing Profile & Reimbursement Data policy alerts

Burlington Pediatric Association, P.C. — Billing Profile & Reimbursement Data

Sign up for Burlington Pediatric Association, P.C. — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References