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

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

Miami Children's Hospital Pathologists, PA (NPI 1205800638)

Miami Children's Hospital Pathologists, PA is a anatomic pathology & clinical pathology physician provider located in Miami, Florida. This profile covers 0 Medicare and 183 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	Miami Children's Hospital Pathologists, PA
Address	3100 Sw 62nd Ave
City	Miami
State	FL
ZIP	33155
Taxonomy	Anatomic Pathology & Clinical Pathology Physician
NPI Enumerated	February 14, 2006

Payer Source	Total Paid
Medicaid	$10.5M
Medicare	$0

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

183 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	16,210	$100	$1.6M
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	7,940	$160	$1.3M
82805	The lab analyst measures any number of blood gas parameters using a blood gas analyzer. The test must also include the O2 saturation by direct measurement.	71,400	$20	$1.2M
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,…	66,870	$10	$936.1K
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	28,820	$30	$720.5K
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.	40,860	$20	$612.9K
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…	25,930	$20	$492.7K
87507	The lab analyst performs a test to detect 12 to 25 types or subtypes of a pathogen, such as Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia, that affects the gastrointestinal…	6,210	$80	$490.7K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	153,500	$1	$460.5K
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	66,620	$1	$199.8K

Showing 1–10 of 183

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Florida Distribution

Miami Children's Hospital Pathologists, PA — 20 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Florida

Full comparison — all codes billed, vs. Florida median

183 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	31	90	550	$110	$284.8K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	196	320	750	$40	$232.7K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	58	640	4,400	$10	$193.4K
84520	The lab analyst performs a test to measure the amount of urea nitrogen in patient blood.	144	300	1,170	$60	$186K
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	59	70	180	$20	$178K
82310	The lab analyst measures the calcium level, primarily on a serum sample.	194	220	880	$50	$151.3K
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	4	160	450	$50	$115.7K
86480	The lab analyst performs a test to evaluate a cell mediated immunity gamma interferon antigen response to certain tuberculosis, or TB, antibodies.	10	40	170	$20	$114.7K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	40	440	610	$40	$111.5K
83970	Parathyroid hormone test measures the level of PTH in the blood. This test is done to ascertain the level of calcium and evaluate the parathyroid function.	124	460	510	$50	$110.2K

Showing 1–10 of 183

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Variety Children's Hospital	FL	Children's Hospital	$0	$175.3M
Nicklaus Children's Pediatric Specialists, LLC	FL	Pediatric Emergency Medicine (Pediatrics) Physician	$0	$66.2M
Alternative Medical Healthcare Services, Corp.	FL	Home Health Agency	$0	$61.9M
Harmony Homes Of Miami, Inc	FL	Home Health Agency	$0	$41.7M
Hha Home Services Corp	FL	Developmentally Disabled Services Day Training Agency	$0	$30M
Bocasa Gourmet, LLC.	FL	Attendant Care Provider	$0	$24.8M
Continental Home Health Care, Inc.	FL	Home Health Agency	$0	$23.4M
Preferred Home Health Care, Inc.	FL	Home Health Agency	$0	$15.7M
First Quality Medical Supplies, Inc	FL	Durable Medical Equipment & Medical Supplies	$0	$14.8M
Syx, Corp.	FL	Community/Behavioral Health Agency	$0	$13.4M

Miami Children's Hospital Pathologists, PA — Billing Profile & Reimbursement Data

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Miami Children's Hospital Pathologists, PA — 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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