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

Why is the Medicaid comparison limited to New York 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. New York (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.

The Childrens Medical Group (NPI 1841224508)

The Childrens Medical Group is a pediatrics physician provider located in Poughkeepsie, New York. This profile covers 0 Medicare and 87 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	The Childrens Medical Group
Address	301 Manchester Rd Ste 105
City	Poughkeepsie
State	NY
ZIP	12603
Taxonomy	Pediatrics Physician
NPI Enumerated	July 10, 2006

Payer Source	Total Paid
Medicaid	$28.6M
Medicare	$0

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

87 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…	83,530	$100	$8.4M
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…	55,470	$150	$8.2M
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…	18,140	$120	$2.1M
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…	15,060	$130	$1.9M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	14,030	$130	$1.8M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	10,100	$140	$1.4M
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	28,680	$50	$1.3M
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	50,210	$20	$1.1M
99051	The provider sees a patient during regular office hours that occur outside of traditional office hours, i.e., in the evening, on a weekend, or on a holiday.	42,670	$20	$682.6K
36416	In this procedure, the provider pricks the patient’s finger, heel, or ear with a pointed instrument and collects specimen of droplets of blood by pressing the pricking site.	40,610	$10	$365.5K

Showing 1–10 of 87

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New York Distribution

The Childrens Medical Group — 15 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New York

Full comparison — all codes billed, vs. New York median

87 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	148	19,110	360	$70	$321K
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…	94	16,550	220	$90	$186.8K
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…	34	1,150	480	$70	$178K
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	1,420	490	$70	$176.8K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	1,294	5,420	210	$70	$154.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	40	1,560	470	$70	$142.7K
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…	526	2,050	90	$140	$121.2K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	71	1,660	160	$20	$106.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	35	1,480	310	$70	$99.2K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	175	750	170	$20	$90K

Showing 1–10 of 87

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dutchess Ambulatory Surgical Center	NY	Ambulatory Surgical Clinic/Center	$3M	$0
Deepesh Patel	NY	Internal Medicine Physician	$1.6M	$218.1K
Lexington Center For Recovery, Inc.	NY	Methadone Clinic	$359.8K	$823.1K
Kishor Zinzuvadia	NY	Psychiatry Physician	$368.7K	$362.4K
Scott Kahn	NY	Urology Physician	$410.9K	$10.3K
Kyle Taft	NY	Physical Therapist	$400.5K	$5K
Daniel Katz	NY	Urology Physician	$375.1K	$6.6K
Neil Kocher	NY	Urology Physician	$322.5K	$1.6K
Sumita Mazumdar	NY	Internal Medicine Physician	$155.9K	$167.7K
Michael Solliday	NY	Urology Physician	$295.1K	$9.4K

The Childrens Medical Group — Billing Profile & Reimbursement Data

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The Childrens Medical Group — 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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