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

Why is the Medicaid comparison limited to Connecticut 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. Connecticut (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 Medical Associates, P.C. (NPI 1427275635)

Children's Medical Associates, P.C. is a pediatrics physician provider located in Ansonia, Connecticut. This profile covers 0 Medicare and 40 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 Medical Associates, P.C.
Address	20 Westfield Ave
City	Ansonia
State	CT
ZIP	06401
Taxonomy	Pediatrics Physician
NPI Enumerated	April 19, 2007

Payer Source	Total Paid
Medicaid	$2.9M
Medicare	$0

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

40 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…	13,140	$70	$893.6K
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…	6,830	$100	$676K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	10,220	$20	$234.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2,360	$100	$228.9K
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…	2,220	$100	$224.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1,530	$100	$154K
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…	1,210	$90	$114.1K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	4,720	$20	$103.7K
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…	5,380	$20	$91.4K
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…	8,960	$10	$62.7K

Showing 1–10 of 40

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Connecticut Distribution

Children's Medical Associates, P.C. — 0 of 23 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Connecticut

Full comparison — all codes billed, vs. Connecticut median

40 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…	230	1,590	740	$50	$331.8K
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…	155	1,710	750	$30	$243.3K
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…	50	170	850	$80	$203.5K
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…	64	160	680	$70	$166.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	46	180	710	$70	$151.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	45	170	410	$70	$98K
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…	40	100	2,240	$1	$67.1K
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…	35	140	1,300	$10	$51.7K
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.	153	290	470	$10	$41.9K
99174	The provider uses instruments to conduct a vision screening exam on both eyes. The procedure includes analysis and report.	28	60	510	$20	$36.9K

Showing 1–10 of 40

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bhcare, Inc.	CT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$13.9M
Pediatric & Adolescent Healthcare, PC	CT	Pediatrics Physician	$0	$7.3M
Behavior Analytic Services Of Connecticut, LLC	CT	Behavior Analyst	$0	$2M
City Of Ansonia	CT	Ambulance	$163.2K	$1.7M
Ansonia Public School District, Ansonia Board Of Education	CT	Local Education Agency (LEA)	$0	$1.7M
Myeyedr Optometry Of Connecticut, LLC	CT	Optometrist	$0	$1.6M
Connecticut Cvs Pharmacy, L.L.C.	CT	Pharmacy	$217.2K	$235.4K
Michael Lipcan	CT	Gastroenterology Physician	$182.5K	$0
Luke Jeffries	CT	Foot & Ankle Surgery Podiatrist	$38.5K	$90.4K
Roman Spivak	CT	Pulmonary Disease Physician	$96K	$0

Children's Medical Associates, P.C. — Billing Profile & Reimbursement Data

Sign up for Children's Medical Associates, P.C. — Billing Profile & Reimbursement Data policy alerts

Children's Medical Associates, P.C. — Billing Profile & Reimbursement Data

Sign up for Children's Medical Associates, P.C. — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References