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

Why is the Medicaid comparison limited to Maryland 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. Maryland (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 Group, P.A. (NPI 1528165750)

Children's Medical Group, P.A. is a specialist provider located in Cumberland, Maryland. This profile covers 0 Medicare and 64 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 Group, P.A.
Address	500 Greene St
City	Cumberland
State	MD
ZIP	21502
Taxonomy	Specialist
NPI Enumerated	September 20, 2006

Payer Source	Total Paid
Medicaid	$6.8M
Medicare	$0

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

64 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…	35,980	$80	$2.8M
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…	8,320	$100	$807.2K
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…	7,450	$90	$655.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5,700	$100	$553.1K
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…	4,200	$100	$411.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	3,140	$110	$336.3K
94760	The provider takes a single measurement of the patient’s oxygen saturation using a sensor on the ear or finger.	58,110	$1	$174.3K
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…	15,770	$10	$141.9K
90698	This code represents a combination vaccine product administered into the muscle to protect against five diseases: diphtheria, tetanus, pertussis, Haemophilus influenzae type b (Hib), and polio.	5,600	$20	$100.9K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	4,100	$20	$94.3K

Showing 1–10 of 64

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maryland Distribution

Children's Medical Group, P.A. — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. Maryland median

64 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	982	2,200	890	$110	$596.1K
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…	648	3,670	680	$90	$310K
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…	51	3,280	610	$80	$296.1K
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	330	800	$110	$228.7K
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…	11	290	730	$100	$212.2K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	486	610	520	$50	$178.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	19	350	490	$110	$172.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	28	320	290	$120	$128K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	8	40	100	$30	$119.8K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	608	1,090	90	$200	$101.4K

Showing 1–10 of 64

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Archway Station Inc	MD	Rehabilitation Psychologist	$0	$18.5M
Board Of Education Of Allegany County	MD	Audiologist	$0	$17.2M
Associated Catholic Charities	MD	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$17M
Allegany County Health Department/joseph S Massie Unit	MD	Substance Abuse Rehabilitation Facility	$0	$16.3M
Committed To Change, P.C.	MD	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$13.3M
Ats Of Cecil County, Inc.	MD	Methadone Clinic	$0	$11.9M
Committed To Change, P.C.	MD	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$10.2M
Wmrs Inc	MD	Methadone Clinic	$230.8K	$9M
Upmc Western Maryland Corporation	MD	Radiology Clinic/Center	$917.4K	$7.3M
Cumberland Covenant House LLC	MD	Adult Day Care Clinic/Center	$0	$8.2M

Children's Medical Group, P.A. — Billing Profile & Reimbursement Data

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Children's Medical Group, P.A. — 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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