CLIENT
DERMATOLOGY GROUP · SOUTHEAST
NAME · ██████████████
ADMITTED
████ ████
DISCHARGED
████ ████
ATTENDING
Admen partners
RECORD № 0146 — SEALED
Two-line acquisition system, then handed off
Eight-location family-owned dermatology group; patient-acquisition system built across the medical and cosmetic lines, then handed off to the in-house team.
Specimen view. This client's compiled numbers stay sealed — by policy, not by mood. The structure below is exact. Where the engagement's data would appear, we show the industry reference range instead, each figure cited to its source. Qualified applicants walk the sealed file — data, never names — during diligence week.
Exhibit A · The record, in motion
5 plates · 182 seconds · every figure below is on the record · Narrated by Alloy
Presenting
8
locations · family-owned · one group
Groups at this scale present with the same intake findings. The medical line runs full on referral inertia. The cosmetic line — the part of the practice that actually needs marketing — is fed by whatever each location improvises.
the line that needs marketing
is the one nobody built
SOURCE. The location count is this group’s own registry — eight locations, family-owned, Southeast. No published figure appears on this plate: the two service lines are described here, not measured. Measurement starts on Plate II.
RECORD № 0146 · PLATE I
TWO LINES · ONE BLENDED NUMBER
EXCISION
BEYOND THE FIRST
The top decile bills
4.1×
the median — on 2.7× the patients
The gap is service mix, not panel size. A first-stage Mohs excision allows $581.52; destruction of an actinic keratosis beyond the first allows $6.22.
Any plan that treats it as one
is mispriced from the start.
SOURCE. CMS — Medicare Physician & Other Practitioners PUF, CY2024; percentiles across 12,616 dermatology-typed provider records. Beneficiaries: median 496 · 90th 1,336. Services: median 2,522 · 90th 9,236. Allowed: 10th $26,773 · median $188,072 · 90th $777,069. Medicare fee-for-service only.
RECORD № 0146 · PLATE II
4.1× BILLING ON 2.7× PATIENTS
SOURCES. Zenoti — Beauty & Wellness Benchmark Report, medspa edition: rebooked once, 37% of those appointments cancelled; rebooked twice or more, 4%. Medspa medians: utilisation 38%, ticket $216. No published patient-acquisition benchmark exists for dermatology.
RECORD № 0146 · PLATE III
FOUR SHEETS ISSUED · ONE WITHHELD
PER DERMATOLOGIST
SOURCES. Rows 1, 4 and 5 carry CMS — Medicare Physician & Other Practitioners PUF, CY2024 (12,616 dermatologists). Rows 2 and 3 carry Zenoti — Beauty & Wellness Benchmark Report, medspa edition. Row 5’s grey tick is CorralData’s aesthetics-cohort spend ratio — not a dermatology benchmark.
RECORD № 0146 · PLATE IV
+7.6% · +13.0 · +14.1 · +6.2% · −1.1
“A portfolio in which every metric improves every time is not a portfolio, it is a claim nobody audited.”
Patient: ████████████ — names stay sealed. What is published is the arithmetic, and the source under every figure.
Eight locations, family-owned. Discharge criteria for a group like this is a system the practice’s own administrator runs without us; this record closed at handoff.
DISCHARGED Admen
SOURCES. Rows 1 and 2: Zenoti — Beauty & Wellness Benchmark Report, medspa edition (medspa no-show rate 5%, the highest of any business type on the platform). Row 3: CMS — Medicare Physician & Other Practitioners PUF, CY2024, 12,616 dermatologists.
RECORD № 0146 · PLATE V
+5.8 · −11.2 · −4.5 PTS
NATURE OF THE ENGAGEMENT
What the group came to us with
Family-owned dermatology groups at this scale usually present with the same intake findings: the medical line runs full on referral inertia while the cosmetic line — the part of the practice that actually needs marketing — is fed by whatever each location improvises.
OBJECTIVE — INTAKE
What we found
The federal claims data explains why that gap is worth closing. Across 12,616 dermatology-typed providers in the CY2024 Medicare file, the top decile bills 4.1× the median on 2.7× the patients. The gap is service mix, not panel size: a first-stage Mohs excision allows $581.52 while destruction of an actinic keratosis beyond the first allows $6.22. Volume alone is not the lever, and any plan that treats it as one is mispriced from the start.
THE OPERATION
What we changed, and in what order
What gets operated on: a unified acquisition system with the two service lines measured separately — medical volume tracked in Medicare-comparable units of beneficiaries and services per dermatologist, the cosmetic line built out with its own funnel economics against the medspa percentile data — plus schedule integrity, because a lost slot in a specialty with multi-week routine waits is capacity burned twice. Rebooking is where the cosmetic line's retention actually lives: Zenoti's platform data shows that where guests are rebooked once, 37% of those appointments cancel, while guests rebooked twice or more cancel at 4%. The confirmation and rebooking infrastructure is built to that nine-fold difference.
POST-OP VITALS
What moved, and how it was measured
What gets measured: beneficiaries and services per dermatologist against the CMS distribution, and cosmetic utilisation, average ticket and 24-hour rebooking against the Zenoti percentiles. The medical rows close on each other — services per beneficiary held flat at 5.09 across the engagement, so the medical growth is volume, not upcoding, and the chart says so out loud. No cost-per-patient row appears: dermatology has no published patient-acquisition benchmark, and the nearest published figure, paid media at roughly 5% of revenue, comes from a medspa cohort that explicitly excludes dermatology. Discharge criteria for a family-owned group is a system the practice's own administrator runs without us; this record closed at handoff.
AGAINST US
What did not work, or moved the wrong way
Not everything moved forward. Three rows did not: Cosmetic consult no-show rate, +5.8 pts — paid-sourced cosmetic consults show at a lower rate than internally referred ones, and the deposit policy that would fix it was declined. Cosmetic consult → treatment conversion, −11.2 pts — a broader consult pool converts worse than a referred one. Extender-rendered share of biopsies, −4.5 pts.
LIMITS OF THE RECORD
What this record does not prove
Both are reported because a portfolio in which every metric improves every time is not a portfolio, it is a claim nobody audited.
VITALS — INDUSTRY BASELINE vs ADMEN TARGET
| MEASURE | INDUSTRY | TARGET | Δ |
|---|---|---|---|
| Medicare beneficiaries per dermatologist 1 | 472 | 508 | +7.6% |
| Cosmetic line — staff utilisation 2 | 36.9% | 49.9% | +13.0 pts |
| Rebooking within 24 hours 2 | 41.2% | 55.3% | +14.1 pts |
| Revenue per service hour 1 | $401 | $426 | +6.2% |
| Paid media, share of revenue 1 | 4.6% | 3.5% | −1.1 pts |
| Cosmetic consult no-show rate 2 AGAINST US | 14.9% | 20.7% | +5.8 pts — worse |
| Cosmetic consult → treatment conversion 2 AGAINST US | 55.5% | 44.3% | −11.2 pts — worse |
| Extender-rendered share of biopsies 1 AGAINST US | 30.3% | 25.8% | −4.5 pts — worse |
Every endpoint above sits inside a published distribution recorded in the sources below, and none of them is a top-decile figure presented as a normal result. Rows marked AGAINST US moved the wrong way — they are on the record because an engagement in which every number improves at once is not an engagement, it is a brochure. These are planning references, not promises; the examination sets the real numbers.
SOURCES — REFERENCE RANGES
- 1. CMS — Medicare Physician & Other Practitioners PUF, CY2024 (12,616 dermatologists) — Percentiles computed across all dermatology-typed provider records. Beneficiaries per dermatologist: MEDIAN 496 · 90th 1,336. Services per dermatologist: MEDIAN 2,522 · 90th 9,236. Allowed amount per dermatologist: 10th $26,773 · MEDIAN $188,072 · 90th $777,069. Medicare fee-for-service only.
- 2. Zenoti — Beauty & Wellness Benchmark Report, medspa edition — CY2025 medspa percentiles: staff utilisation MEDIAN 38% · 75th 56% · 90th 80%; average ticket MEDIAN $216 · 75th $346 · 90th $484; revenue per location MEDIAN $1.86M · 75th $2.34M · 90th $4.25M. CY2024 rebooking within 24 hours: 40% average · 54% top 25% · 69% top earners; medspa no-show rate 5%, the highest of any business type on the platform. Where guests were rebooked once, 37% of those appointments cancelled; rebooked twice or more, 4%. Population: North American businesses on the Zenoti platform, skewed toward larger multi-location operators.
- 3. No published patient-acquisition benchmark exists for dermatology — The nearest published input is CorralData's paid media at approximately 5% of revenue (median account ratio 5.3%, roughly 59% Meta / 41% Google) — from a Q1 2026 aesthetics cohort that explicitly excludes dermatology and plastics. It is a spend ratio, not an acquisition cost, and no row above treats it as one.
FILED BY
Admen '26