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

Why is the Medicaid comparison limited to Wisconsin 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. Wisconsin (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 (NPI 1932454089)

Field	Value
Entity Type	Organization
Organization	Children's Medical Group
Address	5433 W Fond Du Lac Ave
City	Milwaukee
State	WI
ZIP	53216
Taxonomy	Pediatrics Physician
NPI Enumerated	July 16, 2012

Payer Source	Total Paid
Medicaid	$4.6M
Medicare	$0

Medicaid: Complete Services Breakdown

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…	23,220	$40	$1M
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…	11,140	$70	$779.7K
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…	10,030	$60	$581.8K
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…	7,860	$60	$471.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5,800	$60	$330.8K
99173	The provider checks the eyesight in both eyes of a pediatric patient by asking him to read letters of varying sizes on a standard chart, such as a Snellen’s chart, which he keeps 20 feet away from…	11,630	$20	$209.4K
3008F	No Summary found for this code	22,740	$10	$204.7K
92551	The provider delivers a limited series of tones or sounds to a patient to determine if the patient’s hearing is in an acceptable range to detect hearing problems.	11,270	$10	$135.3K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	1,100	$100	$105.8K
83655	The lab analyst performs a test to measure the amount of lead in the patient specimen. A typical aim of the test is to check for lead exposure.	8,650	$10	$103.8K

Showing 1–10 of 64

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wisconsin Distribution

Children's Medical Group — 13 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

64 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…	116	1,630	270	$40	$205.3K
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…	65	1,760	250	$40	$173.2K
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…	10	190	370	$60	$107.4K
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…	98	260	750	$40	$99K
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…	5	210	340	$60	$98.9K
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…	105	350	210	$60	$95.8K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	159	170	330	$80	$90.9K
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,…	187	690	160	$60	$90.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	9	200	200	$60	$64.2K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	137	230	1,030	$10	$56.3K

Showing 1–10 of 64

Related Providers

Other providers that share a Tax Identification Number (TIN) with Children's Medical Group, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Medical Group	WI	Pediatrics Physician	$0	$3.6M
Children's Medical Group	WI	Pediatrics Physician	$0	$3.1M
Children's Medical Group	WI	Pediatrics Physician	$0	$2.6M
Children's Medical Group	WI	Pediatrics Physician	$0	$2.4M
Children's Medical Group	WI	Pediatrics Physician	$0	$2.1M
Children's Medical Group	WI	Pediatrics Physician	$0	$1.5M
Children's Medical Group	WI	Pediatrics Physician	$0	$1.3M
Jennifer Schreiber	DC	Psychiatry Physician	$13.6K	$0
Peter Roloff	WI	Pediatrics Physician	$8.7K	$530

Nearby Providers

Other providers in the same ZIP code as Children's Medical Group, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Samir Mullick Md Sc	WI	Pediatrics Physician	$0	$11.4M
Planned Parenthood Of Wisconsin, Inc	WI	Ambulatory Family Planning Facility	$0	$10.6M
Trinity Home Health Care Inc.	WI	Home Health Agency	$0	$10.5M
Familia Dental Mkemidtown LLC	WI	General Practice Dentistry	$0	$7.4M
Milwaukee Dental Group Sc	WI	General Practice Dentistry	$0	$7.3M
Independent Physicians Of Wisconsin, LLC	WI	Internal Medicine Physician	$0	$6.9M
Ahmed Elhamady	WI	Dentist	$0	$5.4M
Fresenius Medical Care Midwest Dialysis, LLC	WI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3.5M
Blake Dialysis LLC	WI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3.3M
Children's Medical Group	WI	Dentist	$0	$3M

Children's Medical Group — Billing Profile & Reimbursement Data

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Children's 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

Related Providers

Nearby Providers

Frequently Asked Questions

References