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

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

Premier Kids Care, Inc. (NPI 1548237563)

Field	Value
Entity Type	Organization
Organization	Premier Kids Care, Inc.
Address	221 Plaza Dr
City	Monroe
State	GA
ZIP	30655
Taxonomy	Community/Retail Pharmacy
NPI Enumerated	March 8, 2006

Payer Source	Total Paid
Medicaid	$19.6M
Medicare	$0

Key Findings

PREMIER KIDS CARE, INC. is effectively a single-payer Medicaid supplier: it has no Medicare billing on file and $19.6M in lifetime Medicaid revenue, indicating operations are concentrated in Medicaid-funded durable medical equipment and diabetes supplies for pediatric or Medicaid-covered populations. The absence of Medicare revenue suggests the organization either does not serve Medicare beneficiaries or is not enrolled to bill Medicare.

Revenue is highly concentrated in a small set of supplies: the top three Medicaid codes (A9274, A9276, E0784) together account for 84.1% of the provider's total Medicaid revenue, signaling a narrow product mix focused on insulin delivery and continuous glucose monitoring (CGM) systems and related pumps. This concentration implies the business model centers on recurring supply and device billing rather than a broad pharmacy product portfolio.

The code mix (A9274, A9276, E0784, plus A9277 and A9278) points to a specialization in diabetes management technology: external ambulatory insulin delivery systems, CGM sensors, transmitters and receivers, and external insulin infusion pumps. That pattern is consistent with a community/retail pharmacy that has positioned itself to supply durable medical equipment and consumables for diabetes care, likely supporting ongoing, daily-use items (sensors and pump supplies) rather than one-time products.

PREMIER KIDS CARE is a dominant in-state supplier for several key diabetes device codes: it ranks #1 of 1 providers in-state for A9274 (41.3% of their Medicaid revenue) and for A9277 and A9278, and ranks #1 of 2 providers for A9276 and E0784 (where it sits at the 100th percentile among peers for those codes). Those state-ranking positions indicate the provider is a leading or sole supplier in Georgia for multiple CGM and pump device codes, particularly for the higher-revenue items.

Some codes show more typical peer volumes: smaller-value ancillary items such as A4230, A4232, A5120 and others are mostly in the mid to lower percentiles (e.g., A4230 ranks #2 of 3, A4232 ranks #2 of 3, A5120 ranks #3 of 7), which suggests the provider’s competitive advantage is concentrated on primary diabetes devices rather than lower-revenue consumables. This mix could reflect strategic focus on higher-margin durable devices and disposables like sensors and transmitters.

The provider has longstanding enrollment history with an NPI enumerated on 2006-03-08 (~20 years ago), which indicates organizational tenure and experience in Medicaid billing and supplier networks; that timeline supports the observed scale in device-related Medicaid revenue. Longevity combined with concentrated device revenues is consistent with an established supplier relationship with Medicaid plans or durable medical equipment programs.

Price and volume signals are visible in average paid per claim values: high per-claim payments for device codes (for example, $446 avg paid/claim for A9274 and $321 for A9276) alongside very large claim counts (18.2K and 19.8K claims respectively) drive the outsized revenue contributions of those codes. This pattern suggests recurring claims for daily or periodic sensor supplies and device components are the primary revenue engine rather than occasional, high-cost one-off procedures.

Given the profile — no Medicare billing, concentrated Medicaid revenue focused on CGM and insulin delivery-related codes, top in-state ranks for several high-revenue codes — competitive risks and opportunities should be evaluated through the lens of Medicaid program changes and supplier credentialing. Any payer contracting or policy shifts affecting coverage of A9274, A9276, E0784 and related codes would materially affect this provider’s revenue given the 84.1% concentration in the top three codes.

Medicaid: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
A9274	External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories	18,190	$450	$8.1M
A9276	Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply	19,760	$320	$6.3M
E0784	External ambulatory infusion pump, insulin	3,790	$540	$2.1M
A9277	Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system	3,720	$550	$2M
A9278	Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system	1,090	$500	$543.9K
A4230	Infusion set for external insulin pump, non needle cannula type	2,940	$140	$400.2K
A4232	Syringe with needle for external insulin pump, sterile, 3 cc	2,820	$30	$95.8K
A6257	Transparent film, sterile, 16 sq. in. or less, each dressing	1,190	$20	$20.2K
A5120	Skin barrier, wipes or swabs, each	1,210	$10	$6.1K
A4362	Skin barrier; solid, 4 x 4 or equivalent; each	60	$30	$1.6K

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Georgia Distribution

Premier Kids Care, Inc. — 2 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. Georgia median

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A9274	External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories	1	10	18,190	$450	$8.1M
A9276	Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply	1	10	10,120	$320	$3.2M
A9277	Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system	1	10	3,720	$550	$2M
E0784	External ambulatory infusion pump, insulin	1	10	2,050	$510	$1M
A9278	Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system	1	10	1,090	$500	$543.4K
A4230	Infusion set for external insulin pump, non needle cannula type	2	10	2,940	$130	$393.3K
A4232	Syringe with needle for external insulin pump, sterile, 3 cc	2	10	2,820	$30	$108.7K
A4362	Skin barrier; solid, 4 x 4 or equivalent; each	5	10	390	$40	$86.9K
A4456	Adhesive remover, wipes, any type, each	4	10	430	$10	$21.9K
A6257	Transparent film, sterile, 16 sq. in. or less, each dressing	1	10	1,190	$20	$20K

Showing 1–10 of 12

Related Providers

Other providers that share a Tax Identification Number (TIN) with Premier Kids Care, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Premier Kids Care Inc	FL	Community/Retail Pharmacy	$0	$53.1M
Premier Kids Care Inc	TX	Community/Retail Pharmacy	$0	$28.2M

Nearby Providers

Other providers in the same ZIP code as Premier Kids Care, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hospital Physician Services - Southeast Professional Corporation	GA	Hospitalist Physician	$0	$8.4M
Excellent Pediatrics	GA	Primary Care Clinic/Center	$0	$6.3M
Amar Mohan	GA	Internal Medicine Physician	$1.1M	$0
Board Of Commissioners Of Walton County	GA	Land Ambulance	$932.2K	$0
Vest Monroe, LLC	GA	Psychiatric Hospital	$0	$550.4K
Lenox Morris	GA	Family Medicine Physician	$286.5K	$0
Michelle Plaster	GA	Family Medicine Physician	$252.9K	$0
Tiaya Welsh	GA	Family Nurse Practitioner	$163.3K	$0
Bryan Kirkland	GA	Internal Medicine Physician	$132K	$0
Amy Sargent	GA	Family Nurse Practitioner	$110.6K	$0

Premier Kids Care, Inc. — Billing Profile & Reimbursement Data

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Premier Kids Care, Inc. — 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