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

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

Pediatric & Adolescent Advance Care PLLC (NPI 1093159105)

Pediatric & Adolescent Advance Care PLLC is a pediatrics physician provider located in Flint, Michigan. This profile covers 0 Medicare and 107 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	Pediatric & Adolescent Advance Care PLLC
Address	1230 S Linden Rd Ste 3a
City	Flint
State	MI
ZIP	48532
Taxonomy	Pediatrics Physician
NPI Enumerated	April 18, 2013

Payer Source	Total Paid
Medicaid	$10.1M
Medicare	$0

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

107 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…	48,320	$100	$4.7M
D0190	N/A	46,970	$20	$704.5K
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…	7,450	$90	$633.1K
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…	7,340	$70	$528.2K
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…	7,010	$70	$504.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	4,050	$80	$336.4K
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…	2,790	$120	$334.4K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	10,300	$30	$298.6K
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…	2,790	$100	$287.1K
87631	The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,…	2,610	$110	$282.3K

Showing 1–10 of 107

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

Pediatric & Adolescent Advance Care PLLC — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

107 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…	49	4,380	1,000	$70	$289.9K
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…	802	4,770	1,060	$50	$247.8K
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…	49	670	730	$60	$140K
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…	47	590	850	$50	$134.5K
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…	110	1,170	170	$90	$107.9K
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…	165	1,860	220	$90	$96.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	73	720	420	$60	$93.9K
99205	The provider sees a new 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 provider…	88	490	90	$110	$68.4K
17110	The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or…	158	170	200	$60	$67.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	128	720	220	$60	$60.1K

Showing 1–10 of 107

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Alternative Community Living, Inc.	MI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$63.3M
Hope Network S E	MI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$48.6M
Mclaren Flint	MI	General Acute Care Hospital	$0	$43.4M
Alternative Community Living, Inc.	MI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$30.5M
Bio-med Behavioral Health Services	MI	Addiction (Substance Use Disorder) Counselor	$0	$15.4M
Flint Neurological Centre PC	MI	Specialist	$0	$10.7M
Homes Of Opportunity Incorporated	MI	Community/Behavioral Health Agency	$0	$9.8M
Mclaren Flint	MI	General Practice Physician	$0	$7.3M
Sacred Heart Rehabilitation Center, Inc	MI	Community/Behavioral Health Agency	$0	$6.6M
Pulmonary Associates, PC	MI	Pulmonary Disease Physician	$0	$6.3M

Pediatric & Adolescent Advance Care PLLC — Billing Profile & Reimbursement Data

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Pediatric & Adolescent Advance Care PLLC — 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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