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.

Hillsdale Pediatric Clinic PC (NPI 1972765501)

Hillsdale Pediatric Clinic PC is a pediatrics physician provider located in Sterling Heights, Michigan. This profile covers 0 Medicare and 70 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	Hillsdale Pediatric Clinic PC
Address	3755 15 Mile Rd
City	Sterling Heights
State	MI
ZIP	48310
Taxonomy	Pediatrics Physician
NPI Enumerated	June 25, 2008

Payer Source	Total Paid
Medicaid	$7M
Medicare	$0

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

70 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…	44,680	$60	$2.6M
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…	19,950	$90	$1.7M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	3,710	$70	$274.2K
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…	3,600	$80	$273.5K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	2,120	$110	$242.1K
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.	8,720	$20	$191.8K
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…	2,310	$70	$154.5K
99495	The provider manages the care of a patient during the transition to home care after discharge from a healthcare facility. The patient’s care requires at least moderate medical decision making,…	1,780	$90	$153.2K
99442	N/A	2,780	$60	$152.9K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	15,080	$10	$150.8K

Showing 1–10 of 70

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

Hillsdale Pediatric Clinic PC — 8 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

70 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…	159	4,380	1,000	$70	$289.9K
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…	84	4,770	1,060	$50	$247.8K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	22	140	290	$80	$161.3K
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…	118	670	730	$60	$140K
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…	169	590	850	$50	$134.5K
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…	1,086	1,170	170	$90	$107.9K
99204	The provider sees a new 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 provider…	531	1,860	220	$90	$96.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	85	720	420	$60	$93.9K
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…	482	2,000	260	$60	$84.2K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	236	860	260	$70	$71.6K

Showing 1–10 of 70

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sollars And Associates	MI	Psychologist	$0	$12.4M
Ezra Care LLC	MI	In Home Supportive Care Agency	$0	$11.9M
Universal-macomb Ambulance Service, Inc.	MI	Land Ambulance	$904.4K	$7.8M
Care And Transformation Center	MI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.6M
Gogue Pediatrics, P.C.	MI	Pediatric Adolescent Medicine Physician	$0	$6.1M
Marogy Hy Pplc	MI	Dentist	$0	$5.8M
Rana Azzo, Dds, PLLC	MI	Dental Clinic/Center	$0	$5.6M
Prestige Specialty Pharmacy LLC	MI	Community/Retail Pharmacy	$1M	$0
Srinivas Koneru	MI	Cardiovascular Disease Physician	$984.1K	$0
Mark Rosenberg	MI	Family Medicine Physician	$400.6K	$0

Hillsdale Pediatric Clinic PC — Billing Profile & Reimbursement Data

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Hillsdale Pediatric Clinic PC — 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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