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 Specialty Group, Inc. (NPI 1942970405)

Children's Specialty Group, Inc. is a pediatrics physician provider located in Milwaukee, Wisconsin. This profile covers 0 Medicare and 150 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 Specialty Group, Inc.
Address	9000 W Wisconsin Ave
City	Milwaukee
State	WI
ZIP	53226
Taxonomy	Pediatrics Physician
NPI Enumerated	September 16, 2021

Payer Source	Total Paid
Medicaid	$10.4M
Medicare	$0

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

150 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	14,210	$150	$2.1M
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…	19,730	$70	$1.4M
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…	11,920	$90	$1.1M
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.	19,550	$50	$938.3K
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.	3,510	$200	$702.8K
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…	9,640	$50	$472.4K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	2,590	$100	$254.1K
70551	The provider uses magnetic resonance imaging, or MRI, to examine the brain and brain stem. The provider does not administer contrast for this exam.	2,670	$60	$160.4K
95720	A physician or other QHCP reviews recorded events and analyzes spike and seizure detection of a continuous electroencephalography, a study of the electrical activity of the brain. A video is…	1,300	$120	$150.9K
99203	The provider sees a new 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 provider…	1,680	$90	$147.7K

Showing 1–10 of 150

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 Specialty Group, Inc. — 2 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

150 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	39	360	1,550	$70	$614.4K
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.	58	430	760	$60	$484.6K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	124	190	1,790	$90	$390.9K
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.	108	330	1,350	$60	$338K
95720	A physician or other QHCP reviews recorded events and analyzes spike and seizure detection of a continuous electroencephalography, a study of the electrical activity of the brain. A video is…	3	10	1,090	$120	$277.4K
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	3	10	400	$290	$248.4K
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	5	20	830	$140	$245.3K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	5	20	50	$400	$216.3K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	102	220	1,140	$70	$213.3K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	145	220	980	$80	$210.3K

Showing 1–10 of 150

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Hospital And Health System, Inc.	WI	Urgent Care Clinic/Center	$0	$17.7M
Jeffrey Young	WI	Ophthalmology Physician	$697.5K	$0
Megan Maticek	WI	Ophthalmology Physician	$608.3K	$0
Lawrence Platt	WI	Ophthalmology Physician	$359.5K	$0
Jessica Ghaferi	WI	Dermatopathology Physician	$270.9K	$0
William Wirostko	WI	Ophthalmology Physician	$232.5K	$0
Chad Hoitink	WI	Ophthalmology Physician	$199.5K	$0
Geoffrey Wilkes	WI	Ophthalmology Physician	$174.3K	$0
Connor Sullivan	WI	Orthopaedic Hand Surgery Physician	$133K	$0
Edward Barnett	WI	Ophthalmology Physician	$128.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Hospital Of Wisconsin, Inc.	WI	Children's Hospital	$0	$262.3M
Froedtert Memorial Lutheran Hospital, Inc.	WI	General Acute Care Hospital	$0	$157.8M
The Medical College Of Wisconsin, Inc.	WI	Internal Medicine Physician	$17.8K	$74.8M
Emergency Medicine Specialists, S.c.	WI	Emergency Medicine Physician	$0	$35.3M
Wisconsin Diagnostic Laboratories LLC	WI	Clinical Medical Laboratory	$2.3M	$22.7M
Childrens Hospital Of Wisconsin, Inc.	WI	Pediatrics Physician	$0	$19M
Option Care Home Care Inc	WI	Pharmacy	$0	$12.5M
Curative Care Network, Inc.	WI	Rehabilitation Clinic/Center	$0	$12.2M
Brian Blocher	WI	Oral & Maxillofacial Surgery (D.M.D.)	$0	$5.5M
Nicholas Tosi	WI	Retina Specialist (Ophthalmology) Physician	$4.9M	$0

Children's Specialty Group, Inc. — Billing Profile & Reimbursement Data

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Children's Specialty Group, Inc. — 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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