CLIENT
DERMATOLOGY PLATFORM · MULTI-STATE
NAME · ██████████████
ADMITTED
████ ████
DISCHARGED
Ongoing
ATTENDING
Admen partners
RECORD № 0158 — SEALED
44-location platform under active management
Forty-four-location PE-backed dermatology platform under active management; patient acquisition, capacity utilisation and cash-pay mix tracked as valuation levers.
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 · 161 seconds · every figure below is on the record · Narrated by Alloy
Presenting problem
44
Locations · multi‑state
PE‑backed · on different systems
A PE‑backed dermatology platform presents with scale problems, not awareness problems: forty‑four locations across multiple states, acquired practices on different systems, and per‑site economics nobody can compare.
The first act is arithmetic
Intake is a normalisation exercise — every location’s funnel restated in the same units before anything is prescribed.
a datum before a span
SOURCE. The location count is the group’s own registry — 44 locations, PE‑backed, multi‑state, record open. No external benchmark is cited on this plate and none is claimed: the scattered outlines carry no measured value, because at intake no comparable per‑site figure existed.
RECORD № 0158 · PLATE I
44 LOCATIONS · NO COMMON UNIT
How the top decile gets there
Patients 2.7× Billings 4.1× The top decile bills 4.1× the median on 2.7× the patients. The gap between those two bars is service mix — not panel size.What one unit of work allows
$581.52 Mohs, first stage $6.22 Actinic keratosis destruction, each beyond the first Same axis. Same scale. Both are one unit of dermatology.SOURCE. CMS — Medicare Physician & Other Practitioners PUF, CY2024, 12,616 dermatology‑typed providers. Allowed per dermatologist: 10th $26,773 · median $188,072 · 90th $777,069. Top decile bills 4.1× the median on 2.7× the patients. Mohs first stage allows $581.52; AK destruction beyond the first, $6.22.
RECORD № 0158 · PLATE II
$26,773 · $188,072 · $777,069
The two levers
The cosmetic build runs against capacity rather than demand: the two levers move independently and capacity does not move at all.
Paid media, held to a ratio
Held at roughly the published 5% of revenue — median account ratio 5.3%, roughly 59% Meta / 41% Google — so spend scales with revenue rather than ahead of it.
One deliberate omission: no EBITDA multiple appears on this chart. The only multiple band in our register with a named source and a stated population is dental — Dykema’s 9–10× for large DSO platforms.
Transplanting a dental multiple onto a dermatology platform would be exactly the contamination this record exists to avoid. The bridge overleaf is built in revenue, not in enterprise value.
No multiple carriedSOURCES. Capacity and utilisation framed against Zenoti — Beauty & Wellness Benchmark Report, medspa edition (staff utilisation median 38% · 75th 56% · 90th 80%). Paid media against CorralData — Q1 2026 Aesthetics Industry Benchmark: ≈5% of revenue, median account ratio 5.3%, roughly 59% Meta / 41% Google.
RECORD № 0158 · PLATE III
3 PIERS · 9,000 HOURS FLAT
Second bridge — medical line
CMS median$188,072 $180,367 +12.3% $202,552 Intake Credit Current
Decomposition, partial
The record states the endpoint as the product of the two rows above it and does not publish the dollar split between them. The two credit blocks are hatched and drawn as equal halves for exactly that reason.
Split not on the recordSOURCES. Zenoti — Beauty & Wellness Benchmark Report, medspa edition: revenue per location median $1,860,000 · 75th $2,340,000 · 90th $4,250,000; staff utilisation median 38% · 75th 56% · 90th 80%. CorralData — Q1 2026 Aesthetics Industry Benchmark: revenue per service hour ≈$420 median. Medical line: CMS PUF CY2024.
RECORD № 0158 · PLATE IV
+18.1% · +12.3%
share of revenue 4.7% → 5.4%
+0.7 pts worse Medical‑line new‑
patient wait, days 15.9 → 17.5
+10.1% worse Extender‑rendered
share of biopsies 31.7% → 21.1%
−10.6 pts worse Rebooking within
24 hours 38.5% → 27.6%
−10.9 pts worse Depth is the size of the move in that row’s own unit — points or percent. The units are not commensurate and they do not sum. This is a ledger of debits, not a subtraction from the bridge on Plate IV.
What went the other way — four of them
A reader who only sees Medicare allowed per dermatologist at +12.3% has been shown half a record.
Patient: ██████████ — names stay sealed. What is published is the arithmetic and the source under every figure.
Record open · ongoing Admen
SOURCES. Paid media — CorralData, Q1 2026 Aesthetics Industry Benchmark (≈5% of revenue, median ratio 5.3%). Wait days and extender‑rendered biopsy share — CMS PUF CY2024. Rebooking — Zenoti, medspa edition. No published benchmark for wait days, extender share or 24‑hour rebooking appears on this record — those three move against this platform’s own baseline.
RECORD № 0158 · PLATE V
+0.7 · +10.1% · −10.6 · −10.9
Transcript · the narration, in full
I · No datum
Forty-four locations, private-equity backed, multi-state, acquired practices on different systems. The presenting problem is scale, not awareness: per-site economics nobody can compare. At intake no comparable per-site figure existed. No external benchmark is claimed here, and that absence is the presenting problem, not a measurement. A bridge cannot be built until every block sits on one line.
II · The ladder
Medicare claims, 2024 — 12,616 dermatology-typed providers. Allowed per dermatologist: 10th percentile $26,773, median $188,072, 90th $777,069. The top decile bills 4.1 times the median on 2.7 times the patients: service mix, not panel size. Mohs, first stage, allows $581.52; actinic keratosis destruction beyond the first, $6.22.
III · The piers
Three piers under one deck: centralised acquisition, confirmation and rebooking infrastructure, and a cash-pay cosmetic line. Service hours held flat at roughly 9,000 per location, so the levers are utilisation and revenue per service hour. Paid media held to about 5% of revenue. No EBITDA multiple appears on this chart. The only multiple band with a named source is dental.
IV · The bridge
Cash-pay revenue per location, $1.44 million to $1.70 million — up 18.1%. Capacity contributed zero: about 9,000 service hours, held flat. Utilisation, 36.6% to 52.4%. Revenue per service hour, $359 to $399. Both endpoints sit below the Zenoti median of $1,860,000 per location. The dollar split between those two rows is not on the record.
V · Below the line
Four rows went the other way. Paid media share of revenue, 4.7% to 5.4%, 0.7 points worse. Medical-line new-patient wait, 15.9 days to 17.5, 10.1% worse. Extender-rendered share of biopsies, 31.7% to 21.1%. Rebooking within 24 hours, 38.5% to 27.6%. No published benchmark exists for the last three; they move against this platform's own baseline. No dollar cost is published for any of them.
NATURE OF THE ENGAGEMENT
What the group came to us with
A PE-backed dermatology platform presents with scale problems, not awareness problems: forty-four locations across multiple states, acquired practices on different systems, and per-site economics nobody can compare.
OBJECTIVE — INTAKE
What we found
Intake is a normalisation exercise — every location's funnel restated in the same units before anything is prescribed. The federal claims data sets the frame for the medical line: across 12,616 dermatology-typed providers, allowed amounts run from $26,773 at the tenth percentile to $188,072 at the median to $777,069 at the ninetieth, and the top decile gets there on 2.7× the patients but 4.1× the billings. Service mix is the variable. Everything else is noise around it.
THE OPERATION
What we changed, and in what order
What gets operated on: centralised acquisition with per-site economics, confirmation and rebooking infrastructure, and deliberate construction of the cash-pay cosmetic line — because in this engagement type, service mix is a valuation input rather than a marketing preference. The cosmetic build is run against capacity rather than demand: available service hours are held flat at roughly 9,000 per location while utilisation and revenue per service hour are moved independently. That is why the revenue-per-location row below is not a separate claim — the record does not publish the split between utilisation and rate, so none is asserted here.
POST-OP VITALS
What moved, and how it was measured
What gets measured is what the platform trades on: Medicare allowed per dermatologist against the CMS distribution, cosmetic utilisation and revenue per service hour against the medspa and aesthetics percentile data, cash-pay revenue per location, and paid media held at roughly the published 5% ratio so that spend scales with revenue rather than ahead of it. One deliberate omission: no EBITDA multiple appears on this chart. The only multiple band in our register with a named source and a stated population is dental — Dykema's 9–10× for large DSO platforms — and transplanting a dental multiple onto a dermatology platform would be exactly the contamination this record exists to avoid. This record remains open on a standing operating cadence with the sponsor's team.
AGAINST US
What did not work, or moved the wrong way
What went the other way, 4 of them: Paid media, share of revenue, +0.7 pts — the cash-pay growth was bought, not conjured. Medical-line new-patient wait, days, +10.1% — cosmetic capacity was prioritised and the medical schedule absorbed it. Extender-rendered share of biopsies, −10.6 pts. Rebooking within 24 hours, −10.9 pts.
LIMITS OF THE RECORD
What this record does not prove
A reader who only sees Medicare allowed per dermatologist at +12.3% has been shown half a record.
VITALS — INDUSTRY BASELINE vs ADMEN TARGET
| MEASURE | INDUSTRY | TARGET | Δ |
|---|---|---|---|
| Medicare allowed per dermatologist 1 | $180,367 | $202,552 | +12.3% |
| Cash-pay revenue per location (derived) 2 | $1.44M | $1.70M | +18.1% |
| Revenue per service hour 3 | $359 | $399 | +11.1% |
| Cosmetic line — staff utilisation 2 | 36.6% | 52.4% | +15.8 pts |
| Paid media, share of revenue 3 AGAINST US | 4.7% | 5.4% | +0.7 pts — worse |
| Medical-line new-patient wait, days 1 AGAINST US | 15.9 | 17.5 | +10.1% — worse |
| Extender-rendered share of biopsies 1 AGAINST US | 31.7% | 21.1% | −10.6 pts — worse |
| Rebooking within 24 hours 2 AGAINST US | 38.5% | 27.6% | −10.9 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) — Allowed amount per dermatologist: 10th $26,773 · MEDIAN $188,072 · 90th $777,069. The top decile bills 4.1× the median on 2.7× the patients — service mix, not panel size: first-stage Mohs allows $581.52, destruction of an actinic keratosis beyond the first allows $6.22. The discharge figure sits between the median and the ninetieth; the intake figure sits below the median.
- 2. Zenoti — Beauty & Wellness Benchmark Report, medspa edition — CY2025 medspa percentiles: staff utilisation MEDIAN 38% · 75th 56% · 90th 80%; revenue per location MEDIAN $1,860,000 · 75th $2,340,000 · 90th $4,250,000. Percentiles are carried as published reference only; the endpoints in the row above are this group's own instrumented figures and are not derived from them.
- 3. CorralData — Q1 2026 Aesthetics Industry Benchmark — Revenue per service hour across the cohort: ~$100 floor · ~$295 bottom quartile · ~$420 MEDIAN · ~$700 top decile · $1,500+ top of range. Paid media approximately 5% of revenue, median account ratio 5.3%, roughly 59% Meta / 41% Google. Population: 100+ aesthetics brands on the CorralData platform — dermatology and plastics explicitly excluded, which is why these rows sit against the cosmetic line only.
FILED BY
Admen '26