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

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

University Pediatricians (NPI 1811920549)

Key Findings

Field	Value
Entity Type	Organization
Organization	University Pediatricians
Address	3901 Beaubien
City	Detroit
State	MI
ZIP	48201
Taxonomy	Pediatrics Physician
NPI Enumerated	July 8, 2006

Payer Source	Total Paid
Medicaid	$106.9M
Medicare	$0

UNIVERSITY PEDIATRICIANS is effectively a single‑payer Medicaid provider: there is no Medicare billing on file while total Medicaid revenue is $106.9M. The NPI was enumerated on 2006-07-08 (~20 years ago), indicating an established presence in the market rather than a new entrant. This combination of long tenure and a Medicaid‑only billing footprint suggests the organization’s operations are highly focused on pediatric care reimbursed through Medicaid.

Revenue concentration is meaningful: the top three Medicaid codes (99472, 99284, 99283) account for 34.0% of the provider’s total Medicaid revenue. Individually, 99472 accounts for $15.2M (16.8%), 99284 $8.7M (9.6%), and 99283 $6.9M (7.6%), demonstrating that a relatively small set of high‑volume/high‑value pediatric acute‑care codes drive more than one‑third of Medicaid revenue.

The code mix points to a high-acuity pediatric service line with substantial neonatal and critical‑care capacity. Codes for neonatal/infant critical care such as 99472 ($15.2M, 16.8%), 99469 ($6.5M, 7.2%), and 99468 ($2.8M, 3.0%) appear prominently, indicating ongoing inpatient neonatal critical care and follow‑up services rather than exclusively outpatient pediatrics. These payments and code types are consistent with NICU/PICU activity and resource‑intensive inpatient pediatric care.

Emergency department services are a major operational driver: high-volume ED E/M codes appear throughout the top line items. 99284 has 140.5K claims and $8.7M revenue (9.6%, ranks #11 of 477 in‑state, 98th percentile, labeled an extreme outlier), and 99283 has 112.8K claims and $6.9M (7.6%, ranks #10 of 447, 98th percentile). Additional ED codes (99282, 99285) and very large claim counts (e.g., 53.4K claims for 99282) imply very high ED throughput and staffing/operational scale dedicated to emergency pediatric care.

Substantial inpatient and critical care billing beyond neonatal codes reinforces the high‑acuity profile: critical care 99291 accounts for $3.9M (4.3%, ranks #3 of 274, 99th percentile) and inpatient subsequent visit codes such as 99233 ($4.5M, 4.9%, ranks #3 of 625, 100th percentile) are also major contributors. The presence of multiple inpatient and discharge management codes (e.g., 99223, 99232, 99238, 99239) in top revenue positions indicates the organization manages significant inpatient volume and complex pediatric admissions.

Competitive standing within Michigan is strong and concentrated: the provider ranks at or near the top of the state for many high‑revenue pediatric codes. Several codes are described as "extreme outlier" or "notably above typical state volume," including 99472 (ranks #1 of 17, 100th percentile, extreme outlier), 99468 (ranks #1 of 19, 100th percentile), and multiple ED and inpatient codes at 99–100th percentiles. These rankings indicate UNIVERSITY PEDIATRICIANS is a dominant statewide provider for several specialized pediatric services rather than a modest participant.

Operational and payer implications flow from the data: high claim volumes (for example 140.5K claims for 99284 and 116.7K claims for 99214) combined with concentration in neonatal/critical care and ED services imply substantial clinical capacity, specialized staffing, and facility resources. From a payer or network perspective, the provider’s dominance on multiple state‑level codes and the Medicaid‑centric revenue base suggest it is a critical Medicaid contracting counterparty for pediatric acute and neonatal care in Detroit and potentially surrounding areas.

Medicaid: Complete Services Breakdown

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

178 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	44,770	$340	$15.2M
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.	140,480	$60	$8.7M
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.	112,790	$60	$6.9M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	19,680	$330	$6.5M
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…	116,730	$50	$6M
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…	74,920	$80	$5.9M
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…	73,220	$60	$4.5M
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	31,320	$120	$3.9M
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.	42,800	$90	$3.6M
99468	The provider evaluates and manages the initial care of a newborn or infant less than 28 days of age in a neonatal critical care setting.	3,710	$740	$2.8M

Showing 1–10 of 178

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

University Pediatricians — 23 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

178 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	40	400	1,510	$190	$2.6M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	1	20	1,000	$340	$2.5M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	2	20	2,940	$340	$1.8M
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.	11	480	1,350	$110	$1.7M
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.	10	450	1,540	$90	$1.3M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	2	20	3,450	$100	$916.9K
99468	The provider evaluates and manages the initial care of a newborn or infant less than 28 days of age in a neonatal critical care setting.	1	20	540	$770	$650.1K
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	2	20	1,120	$100	$636.6K
99471	The provider performs initial evaluation and management of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	1	10	240	$660	$570K
99476	The provider performs follow up care for a critically ill child, ages two to five years, in an inpatient setting.	1	10	1,420	$290	$533.7K

Showing 1–10 of 178

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ayse Avcioglu	NY	Emergency Medicine Physician	$136K	$48.3K
Nusrat Javaid	MI	Pediatric Emergency Medicine (Pediatrics) Physician	$92.3K	$0
Michael Behen	MI	Clinical Psychologist	$67.4K	$13.5K
Paolo Aquino	CA	Pediatric Cardiology Physician	$1.8K	$0
Sanjeev Aggarwal	MI	Pediatric Cardiology Physician	$530	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vhs Childrens Hospital Of Michigan Inc	MI	Children's Hospital	$0	$180.4M
University Physician Group	MI	Internal Medicine Physician	$0	$87.4M
Vhs Harper-hutzel Hospital Inc	MI	General Acute Care Hospital	$0	$76.6M
The Children's Center Of Wayne Co., Inc.	MI	Community/Behavioral Health Agency	$0	$74.3M
Vhs Detroit Receiving Hospital Inc	MI	General Acute Care Hospital	$0	$60.6M
Medical Center Emergency Services	MI	Emergency Medical Services (Emergency Medicine) Physician	$0	$44.1M
Barbara Ann Karmanos Cancer Hospital	MI	General Acute Care Hospital	$0	$42.5M
Detroit Central City Community Mental Health Inc.	MI	Federally Qualified Health Center (FQHC)	$0	$29.2M
Vhs University Laboratories Inc	MI	Clinical Medical Laboratory	$677.7K	$26.3M
Vhs Rehabilitation Institute Of Michigan Inc	MI	Rehabilitation Hospital	$0	$24.1M

University Pediatricians — Billing Profile & Reimbursement Data

Sign up for University Pediatricians — Billing Profile & Reimbursement Data policy alerts

University Pediatricians — Billing Profile & Reimbursement Data

Sign up for University Pediatricians — Billing Profile & Reimbursement Data policy alerts

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