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

Why is the Medicaid comparison limited to Minnesota 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. Minnesota (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 Respiratory & Critical Care Specialists. P.A. (NPI 1003816505)

Children's Respiratory & Critical Care Specialists. P.A. is a pediatric pulmonology physician provider located in Minneapolis, Minnesota. This profile covers 0 Medicare and 24 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 Respiratory & Critical Care Specialists. P.A.
Address	2530 Chicago Ave
City	Minneapolis
State	MN
ZIP	55404
Taxonomy	Pediatric Pulmonology Physician
NPI Enumerated	July 26, 2005

Payer Source	Total Paid
Medicaid	$7.5M
Medicare	$0

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

24 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	61,400	$70	$4.1M
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…	21,910	$70	$1.4M
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	4,690	$140	$666.4K
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…	4,520	$100	$443K
94060	The spirometry test is performed with a spirometer. The instrument displays a graphical representation, known as a spirogram, of the test results. The basic forced volume vital capacity (FVC) test is…	8,990	$20	$215.7K
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	790	$250	$193.8K
99254	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider spends…	1,320	$110	$140.7K
99471	The provider performs initial evaluation and management of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	130	$560	$73.2K
94664	The provider educates a patient on the use of an aerosol device, nebulizer, metered dose inhaler, or IPPB device and then has the patient demonstrate her understanding. He does this as part of the…	6,470	$10	$58.3K
94010	The provider or technician administers a spirometry test to assess the patient's respiratory function. The spirometer is attached to a computer that records the total and timed vital capacity…	2,370	$20	$42.6K

Showing 1–10 of 24

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Minnesota Distribution

Children's Respiratory & Critical Care Specialists. P.A. — 2 of 23 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. Minnesota median

24 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1013	Sign language or oral interpretive services, per 15 minutes	167	210	560	$60	$822.1K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	8	120	400	$60	$685.8K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	12	50	310	$130	$678K
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…	101	1,180	1,150	$80	$605.7K
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	3	10	700	$270	$357.1K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	64	90	260	$60	$214.5K
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…	38	420	230	$90	$186.2K
99254	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider spends…	8	30	200	$120	$166.4K
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…	21	60	80	$100	$114.6K
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…	128	350	150	$90	$110.6K

Showing 1–10 of 24

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nu-way House Inc	MN	Substance Abuse Rehabilitation Facility	$0	$200.8M
Childrens Health Care	MN	Children's Hospital	$0	$100M
Midwest Home Health Care, Inc.	MN	Home Health Agency	$0	$73.5M
Midwest Quality Home Care, Inc.	MN	Home Health Agency	$0	$66.7M
Regents Of The University Of Minnesota	MN	Federally Qualified Health Center (FQHC)	$0	$55.2M
Minnesota Professional Health Services,inc	MN	Home Health Agency	$0	$51.9M
Park Ave Center Inc	MN	Substance Use Disorder Rehabilitation Clinic/Center	$0	$50.8M
Minnesota Quality Care, Inc.	MN	Home Health Agency	$0	$48.4M
Direct Home Health Care, Inc.	MN	Home Health Agency	$0	$30.7M
Aaa A-z Friendly Languages Inc	MN	Interpreter	$0	$29.4M

Children's Respiratory & Critical Care Specialists. P.A. — Billing Profile & Reimbursement Data

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Children's Respiratory & Critical Care Specialists. P.A. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References