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.

Guh Kids Mobile Medical Clinic Program, LLC (NPI 1205844032)

Field	Value
Entity Type	Organization
Organization	Guh Kids Mobile Medical Clinic Program, LLC
Address	3800 Reservoir Rd Nw
City	Washington
State	DC
ZIP	20007
Taxonomy	Pediatrics Physician
NPI Enumerated	August 4, 2006

Payer Source	Total Paid
Medicaid	$17.5K
Medicare	$0

Medicaid: Complete Services Breakdown

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

10 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…	200	$60	$12.1K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	200	$20	$3.1K
0001A	N/A	10	$50	$660
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	30	$20	$590
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…	40	$10	$420
D0191	N/A	10	$20	$290
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.	20	$10	$260
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.	20	$10	$80
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	50	$1	$50
96160	The provider administers a questionnaire aimed at helping to identify a specific health risk to a patient, analyzes the results, assigns a score, and documents the findings. Use this code for each…	40	$0	$0

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

Guh Kids Mobile Medical Clinic Program, LLC — 0 of 9 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

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	206	320	620	$50	$313.6K
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.	46	50	150	$10	$18K
96160	The provider administers a questionnaire aimed at helping to identify a specific health risk to a patient, analyzes the results, assigns a score, and documents the findings. Use this code for each…	4	10	340	$20	$15.9K
0001A	N/A	21	20	210	$20	$10.6K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	22	30	410	$10	$10K
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…	18	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.	31	40	280	$1	$8.4K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	49	70	510	$1	$8.3K
D0191	N/A	16	20	250	$10	$5.1K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	53	70	180	$1	$4.5K

Guh Kids Mobile Medical Clinic Program, LLC — Billing Profile & Reimbursement Data

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Guh Kids Mobile Medical Clinic Program, LLC — Billing Profile & Reimbursement Data

Sign up for Guh Kids Mobile Medical Clinic Program, LLC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Frequently Asked Questions

References