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

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

Skagit Pediatrics, LLP (NPI 1992823744)

Field	Value
Entity Type	Organization
Organization	Skagit Pediatrics, LLP
Address	2101 Little Mountain Ln
City	Mount Vernon
State	WA
ZIP	98274
Taxonomy	Pediatrics Physician
NPI Enumerated	March 27, 2007

Payer Source	Total Paid
Medicaid	$6M
Medicare	$0

Medicaid: Complete Services Breakdown

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

63 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…	32,700	$70	$2.3M
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…	12,100	$100	$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…	6,070	$100	$582.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5,350	$90	$503.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,470	$100	$249.2K
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…	2,720	$90	$242K
99429	Use 99429 to report a preventive medicine service that does not have a specific code.	4,390	$30	$123K
92551	The provider delivers a limited series of tones or sounds to a patient to determine if the patient’s hearing is in an acceptable range to detect hearing problems.	16,460	$10	$115.2K
99499	Use 99499 to report evaluation and management services for which there is no specific code available.	4,000	$30	$111.9K
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.	22,850	$1	$91.4K

Showing 1–10 of 63

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Washington Distribution

Skagit Pediatrics, LLP — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. Washington median

63 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…	159	1,820	480	$60	$379.6K
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…	88	1,860	610	$40	$295.5K
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…	63	280	540	$70	$166.5K
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…	32	300	400	$80	$164.4K
D0120	Periodic oral evaluation - established patient	292	920	690	$20	$131.3K
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…	330	540	130	$90	$128.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	29	320	290	$70	$104.8K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	441	730	730	$20	$98.5K
D9999	N/A	87	290	690	$30	$75.9K
87086	Culture, bacterial; quantitative, colony count, urine.	119	120	3,790	$10	$68.7K

Showing 1–10 of 63

Nearby Providers

Other providers in the same ZIP code as Skagit Pediatrics, LLP, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Public Hospital Dist No 1 Skagit	WA	General Acute Care Hospital	$0	$88.6M
Public Hospital Dist No 1 Skagit	WA	General Practice Physician	$0	$24.7M
Eye Associates Surgery Center Inc	WA	Ambulatory Surgical Clinic/Center	$839.9K	$44.4K
Proliance Surgeons Inc P S	WA	Ambulatory Surgical Clinic/Center	$793.8K	$0
Stacia Smith	WA	Orthopaedic Surgery Physician	$324.7K	$0
Dawei Lu	WA	Orthopaedic Surgery of the Spine Physician	$264.1K	$0
Navdeep Dhaliwal	WA	Internal Medicine Physician	$248.8K	$12.2K
Carlindo Da Reitz Pereira	WA	Ophthalmology Physician	$230.4K	$0
Michal Whiton	WA	Radiation Oncology Physician	$229.5K	$0
Ramy Hanna	WA	Clinical Cardiac Electrophysiology Physician	$213.9K	$0

Skagit Pediatrics, LLP — Billing Profile & Reimbursement Data

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Skagit Pediatrics, LLP — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References