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 District of Columbia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to District of Columbia 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. District of Columbia (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.

Childrens Medical Care Center (NPI 1043517154)

Childrens Medical Care Center is a pediatric adolescent medicine physician provider located in Washington, District of Columbia. This profile covers 0 Medicare and 12 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	Childrens Medical Care Center
Address	5425 14th St Nw
City	Washington
State	DC
ZIP	20011
Taxonomy	Pediatric Adolescent Medicine Physician
NPI Enumerated	February 25, 2011

Payer Source	Total Paid
Medicaid	$58K
Medicare	$0

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	190	$90	$18.2K
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…	210	$70	$14.8K
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.	440	$20	$8K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	210	$20	$4.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	40	$100	$3.9K
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…	170	$10	$2.1K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	680	$1	$2K
99173	The provider checks the eyesight in both eyes of a pediatric patient by asking him to read letters of varying sizes on a standard chart, such as a Snellen’s chart, which he keeps 20 feet away from…	430	$1	$1.7K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	30	$50	$1.2K
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…	10	$90	$1.1K

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. District of Columbia Distribution

Childrens Medical Care Center — 0 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — District of Columbia

Full comparison — all codes billed, vs. District of Columbia median

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	109	130	290	$140	$579.2K
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…	26	30	350	$110	$345.1K
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…	204	320	620	$50	$313.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	20	40	330	$100	$251.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	23	30	140	$110	$134.3K
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.	13	40	250	$10	$39.5K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	12	30	150	$10	$17.6K
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…	11	20	140	$10	$8.5K
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.	28	40	280	$1	$8.4K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	28	50	690	$1	$5.7K

Showing 1–10 of 12

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Integrated Community Services, Inc.	DC	Home Health Agency	$0	$145.9M
National Children's Center, Inc.	DC	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$101M
Capital Care, Inc	DC	Home Health Agency	$0	$83.4M
Aba Inc	DC	In Home Supportive Care Agency	$0	$80.8M
Premium Select Home Care Inc	DC	Home Health Agency	$0	$63.9M
Ideal Nursing Services Inc	DC	Home Health Agency	$0	$58M
Total Care Services, Inc.	DC	Developmentally Disabled Services Day Training Agency	$0	$54.7M
Metro Homes Inc	DC	Developmental Disabilities Clinic/Center	$0	$45.1M
Citycare Health Services, Inc	DC	Community/Behavioral Health Agency	$0	$36.4M
Janilcar Inc	DC	Durable Medical Equipment & Medical Supplies	$0	$32.7M

Childrens Medical Care Center — Billing Profile & Reimbursement Data

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Childrens Medical Care Center — 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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