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 Of Salisbury, PA (NPI 1568429538)

Children's Medical Group Of Salisbury, PA is a pediatrics physician provider located in Salisbury, Maryland. This profile covers 0 Medicare and 61 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 Of Salisbury, PA
Address	217 Phillip Morris Dr
City	Salisbury
State	MD
ZIP	21804
Taxonomy	Pediatrics Physician
NPI Enumerated	April 26, 2006

Payer Source	Total Paid
Medicaid	$5M
Medicare	$0

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

61 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	17,020	$100	$1.8M
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	3,720	$330	$1.2M
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…	4,040	$140	$581.5K
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…	6,960	$70	$515.1K
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…	1,680	$90	$154.7K
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…	820	$100	$79.2K
76536	The provider performs real–time ultrasound examination of the soft tissues of the head and neck and records and saves the images for later review.	970	$70	$69.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	680	$100	$66.7K
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…	770	$80	$64.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	600	$100	$58.8K

Showing 1–10 of 61

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 Of Salisbury, PA — 5 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

61 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…	109	3,670	680	$90	$310K
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…	148	450	730	$110	$298.2K
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…	411	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…	160	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…	142	290	730	$100	$212.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	151	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.	126	320	290	$120	$128K
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	2	30	60	$250	$122.1K
76642	In this procedure, the provider performs a focused ultrasound of one breast on a limited area. The procedure includes documentation of the images.	16	40	240	$50	$97.3K
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…	37	1,000	200	$120	$96.3K

Showing 1–10 of 61

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wraparound Maryland, Inc	MD	Case Management Agency	$0	$18.4M
Go-getters, Inc.	MD	Community/Behavioral Health Agency	$0	$14.7M
Board Of Education Of Wicomico County	MD	Local Education Agency (LEA)	$0	$14.6M
Healthport	MD	Community/Behavioral Health Agency	$0	$10.9M
Chesapeake Pediatric & Adolescent Associates, PA	MD	Pediatric Adolescent Medicine Physician	$0	$6.6M
Healthport	MD	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$5.5M
Coastal Hospice Inc	MD	Community Based Hospice Care Agency	$0	$5.3M
Konlian,o'neill & Associates, P.A.	MD	Rehabilitation Practitioner	$0	$5M
James Rial	MD	Ophthalmology Physician	$4.7M	$510
John Butler	MD	Ophthalmology Physician	$4.3M	$0

Children's Medical Group Of Salisbury, PA — Billing Profile & Reimbursement Data

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Children's Medical Group Of Salisbury, PA — 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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