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.

Children's Health Alliance, LLC (NPI 1366709321)

Children's Health Alliance, LLC is a pediatrics physician provider located in Orlando, Florida. This profile covers 0 Medicare and 66 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	Children's Health Alliance, LLC
Address	9145 Narcoossee Rd Ste 103
City	Orlando
State	FL
ZIP	32827
Taxonomy	Pediatrics Physician
NPI Enumerated	April 16, 2012

Payer Source	Total Paid
Medicaid	$9.6M
Medicare	$0

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

66 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…	54,140	$60	$3.5M
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…	12,380	$140	$1.7M
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…	13,850	$100	$1.4M
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…	9,310	$130	$1.2M
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.	26,620	$20	$505.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	3,820	$120	$462.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1,160	$140	$160.5K
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…	12,070	$10	$157K
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	2,800	$60	$153.9K
99439	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	2,510	$50	$112.7K

Showing 1–10 of 66

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

Children's Health Alliance, LLC — 9 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

66 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	31	1,130	780	$90	$210.4K
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…	41	1,050	640	$80	$183.6K
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…	61	5,930	460	$40	$169.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	119	1,120	520	$80	$141.7K
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…	207	6,380	430	$50	$139.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	259	980	360	$80	$97.2K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	794	820	1,430	$1	$92.8K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	351	500	340	$50	$89.7K
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…	721	980	120	$90	$76.8K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	62	110	520	$30	$73.1K

Showing 1–10 of 66

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Nemours Foundation	DE	Multi-Specialty Clinic/Center	$0	$172M
The Nemours Foundation	FL	Children's Hospital	$0	$104.9M
The Nemours Foundation	DE	Children's Hospital	$0	$104M
The Nemours Foundation	FL	Multi-Specialty Clinic/Center	$0	$46.2M
Nemours Children's Health, Downtown Orlando, Specialty Care	FL	Multi-Specialty Clinic/Center	$0	$44.4M
Nemours Children's Health, Jacksonville, Specialty Care	FL	Multi-Specialty Clinic/Center	$0	$23.6M
Sedigheh Ebadi	FL	Pediatrics Physician	$0	$10.1M
Michael Klufas	PA	Ophthalmology Physician	$7M	$0
Richard Kaiser	PA	Ophthalmology Physician	$6.6M	$0
Carl Regillo	PA	Ophthalmology Physician	$6.5M	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kellie Slimick	FL	Nurse Practitioner	$851.3K	$0
David Weinstein	FL	MOHS-Micrographic Surgery Physician	$246.3K	$0
Rachel Ergle	FL	Speech-Language Pathologist	$76K	$0
Protean Biodiagnostics Inc	FL	Clinical Medical Laboratory	$65.3K	$0
Kelsey Calamaro	FL	Physician Assistant	$59.2K	$0
Brian Gurr	FL	Certified Registered Nurse Anesthetist	$45.2K	$0
Sujit Routray	FL	Internal Medicine Physician	$26.2K	$0

Children's Health Alliance, LLC — Billing Profile & Reimbursement Data

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Children's Health Alliance, LLC — 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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