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

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

Arkansas Children's Medical Group PLLC (NPI 1396274841)

Key Findings

Field	Value
Entity Type	Organization
Organization	Arkansas Children's Medical Group PLLC
Address	1 Childrens Way # 844
City	Little Rock
State	AR
ZIP	72202
Taxonomy	Pediatrics Physician
NPI Enumerated	June 8, 2017

Payer Source	Total Paid
Medicaid	$16M
Medicare	$0

This provider is effectively single‑payer in the available data: there is no Medicare billing on file while reported Medicaid revenue totals $16M. The NPI was enumerated 2017-06-08 (~9 years ago), indicating roughly nine years of billed activity under this identifier in the dataset.

Revenue is highly concentrated in a small set of Medicaid encounter codes: the top three Medicaid codes (99284, 99283, T1015) together account for 58.5% of this provider's total Medicaid revenue. Individually those codes report $3.9M (24.8%) for 99284, $2.7M (17.2%) for 99283, and $2.6M (16.6%) for T1015, identifying a narrow set of services that drive most revenue.

The code mix indicates a heavy emergency/acute care footprint: 99284 (62.7K claims, $3.9M) and 99283 (64.3K claims, $2.7M) are the top two revenue drivers and 99285 also contributes materially (17.5K claims, $1.2M). High claim volumes and the E/M descriptors for these codes suggest the organization operates a high‑volume pediatric emergency department or urgent care service line focused on moderate‑ to low‑complexity ED encounters.

Ambulatory and preventive pediatrics are also significant: T1015 clinic visits show 108.5K claims and $2.6M in revenue, and preventive codes 99391 (14.2K claims, $681.6K), 99392 (13.4K claims, $655.9K) and 99393 (7.2K claims, $373.2K) together represent meaningful ancillary revenue. The presence of large volumes of both clinic/all‑inclusive visits and well‑child preventive visits indicates a mixed model that combines acute ED throughput with routine pediatric primary/preventive care.

On competitive standing within Arkansas the provider is a statewide leader for several codes: 99284 and 99283 each rank #2 in‑state at the 99th percentile and are labeled as extreme outliers, while 99391 and 99392 rank in the 98–99th percentiles (also extreme outliers). These rank and percentile positions indicate the provider is a dominant participant in the state for both certain pediatric ED services and well‑child visits.

Secondary service lines and inpatient involvement are present but smaller by revenue: inpatient/observation discharge and subsequent care codes (99238: 7K claims, $265.1K; 99232: 7.2K claims, $246.2K; 99223: 2.5K claims, $244.2K) show the provider bills for inpatient/observation E/M encounters, suggesting integration with hospital‑based care or observation units. The procedural code 54161 (1.5K claims, $228.2K) further indicates the practice performs some outpatient pediatric procedures.

Ancillary testing and immunization lines exist but are minor contributors to Medicaid revenue: respiratory multiplex testing 87631 (672 claims, $79.3K) and strep testing 87651 (1.7K claims, $63.5K) are present, and vaccine codes such as 90670, 90647, and 90697 each account for modest revenue shares. These items reflect expected pediatric ancillary services that complement the high clinic and ED volumes but do not materially drive total revenue.

From an operational and contracting perspective, the provider’s business is concentrated in high‑volume encounter codes (top three = 58.5% of Medicaid revenue) and dominated by ED and clinic visits, which likely shapes staffing, throughput and payer negotiations. That concentration implies leverage and risk are tied to maintaining high encounter volumes for those specific pediatric E/M codes rather than broad diversification across many low‑revenue service lines.

Medicaid: Complete Services Breakdown

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

81 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	62,740	$60	$3.9M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	64,280	$40	$2.7M
T1015	Clinic visit/encounter, all-inclusive	108,460	$20	$2.6M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	17,500	$70	$1.2M
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…	27,270	$30	$818K
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…	14,200	$50	$681.6K
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…	13,390	$50	$655.9K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	4,730	$110	$506.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	7,180	$50	$373.2K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	6,980	$40	$265.1K

Showing 1–10 of 81

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Arkansas Distribution

Arkansas Children's Medical Group PLLC — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arkansas

Full comparison — all codes billed, vs. Arkansas median

81 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	44	530	4,960	$70	$2.6M
0241U	N/A	20	40	1,640	$120	$370.5K
70551	The provider uses magnetic resonance imaging, or MRI, to examine the brain and brain stem. The provider does not administer contrast for this exam.	39	40	160	$280	$278.1K
54161	The provider excises the foreskin of a patient older than 28 days; the provider uses a technique other than a clamp, other devices, or dorsal slit.	2	10	1,520	$210	$271.2K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	2	190	1,780	$50	$231.9K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	10	150	1,240	$50	$208.4K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	2	190	2,020	$40	$191.2K
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…	273	1,520	550	$40	$128.7K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	30	180	320	$40	$121.7K
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…	5	210	500	$50	$106.5K

Showing 1–10 of 81

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Arkansas Childrens Hospital	AR	Children's Hospital	$0	$154.7M
University Of Arkansas For Medical Sciences	AR	General Practice Physician	$0	$55M
Angel One Arkansas Children's Hospital	AR	Ambulance	$0	$20.1M
Above And Beyond Home Care Of Central Arkansas	AR	In Home Supportive Care Agency	$0	$13M
University Of Arkansas For Medical Sciences	AR	Developmental - Behavioral Pediatrics Physician	$0	$7.9M
Arkansas Childrens Hospital	AR	Pediatrics Physician	$0	$6.9M
Twin Rivers Respiratory Care, Inc.	AR	Oxygen Equipment & Supplies (DME)	$0	$2.1M
University Of Arkansas For Medical Sciences	AR	Child & Adolescent Psychiatry Physician	$0	$1.4M
Arkansas Childrens Hospital	AR	Dental Clinic/Center	$0	$1.3M
Sc Pharmacy Group Opco LLC	AR	Community/Retail Pharmacy	$296.2K	$0

Arkansas Children's Medical Group PLLC — Billing Profile & Reimbursement Data

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Arkansas Children's Medical Group PLLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References