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

Why is the Medicaid comparison limited to Louisiana 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. Louisiana (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 Hospital (NPI 1104819366)

Key Findings

Field	Value
Entity Type	Organization
Organization	Children's Hospital
Address	200 Henry Clay Ave
City	New Orleans
State	LA
ZIP	70118
Taxonomy	Children's Hospital
NPI Enumerated	August 23, 2005

Payer Source	Total Paid
Medicaid	$150.9M
Medicare	$0

CHILDREN'S HOSPITAL is effectively a Medicaid-centric provider: there is no Medicare billing on file and total Medicaid revenue on record is $150.9M, indicating the hospital’s payer exposure is overwhelmingly concentrated in Medicaid. This single-payer scale creates sensitivity to Medicaid reimbursement policies and utilization trends rather than cross‑payer dynamics.

Revenue is highly concentrated in a small set of emergency department E/M codes: the top three Medicaid codes (99283, 99284, 99285) account for 65.4% of the provider’s total Medicaid revenue. That concentration signals the ED is the primary revenue engine for the hospital and that shifts in ED volume, coding, or reimbursement for these specific CPTs would materially affect top‑line Medicaid performance.

The facility shows dominant statewide standing on multiple high-volume E/M and outpatient codes. For example, 99283 generates $51.3M (36.7% of Medicaid revenue) and ranks #3 of 266 in-state (99th percentile; extreme outlier), while 99213 ($9.6M, 6.9%) ranks #8 of 3226 (100th percentile; extreme outlier), and 99211 ($3.2M, 2.3%) ranks #1 of 838 (100th percentile; extreme outlier). These ranks indicate the hospital is a major, often top-tier provider of both ED and routine outpatient pediatric visits within the state.

Code-level mix points to a pediatric acute-care and ambulatory hub with substantial diagnostic throughput. High revenues and counts for ED E/M codes (99283/99284/99285) alongside large volumes for office/outpatient E/M codes (99213, 99214, 99211, 99215) suggest integrated ED-to-outpatient follow-up workflows and significant ambulatory clinic activity within the same system.

Laboratory and respiratory testing volume is an important ancillary revenue stream: 87502 ($3.9M, 2.8%) ranks #2 of 206 (100th percentile; extreme outlier), 87635 ($2.3M, 1.7%) ranks #3 of 355 (99th percentile; extreme outlier), and the proprietary respiratory panel 0202U contributes $1.6M (1.2%) and ranks #6 of 60 (92nd percentile). The mix of multiplex influenza, SARS–CoV–2, and RP2.1 testing indicates a sustained high throughput for pediatric respiratory diagnostics.

Several pediatric-specific procedure codes and diagnostics reinforce the children’s hospital profile and service breadth: tympanostomy 69436 ($511.8K) and newborn/child hearing procedures 92551 (25.3K claims, $808.2K) and 92587 ($588.7K) appear in the top 25 revenue list, showing substantial procedural and newborn screening activity typical of a pediatric tertiary center. These services supplement the ED and outpatient revenue base with procedural and diagnostic volumes specific to pediatric care.

Competitive positioning is mixed by code complexity: the provider is a statewide outlier for lower- and moderate-complexity ED visits (99283 at the 99th percentile; 99284 at the 88th percentile) but is less dominant for the highest-complexity ED code 99285 (ranks #68 of 237, 72th percentile). This pattern suggests exceptional volume in lower-to-moderate acuity ED presentations and very large outpatient throughput, with more typical statewide participation in the highest-acuity ED encounters.

The provider has long operational tenure in the NPI registry (enumerated 2005-08-23, ~21 years), which, combined with extreme percentile rankings on multiple core pediatric E/M and lab codes, indicates an established market presence and operational scale in pediatric emergency, outpatient, and diagnostic services within Louisiana.

Medicaid: Complete Services Breakdown

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

336 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	132,530	$390	$51.3M
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.	57,370	$500	$28.7M
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.	19,310	$580	$11.3M
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…	281,940	$30	$9.6M
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…	171,520	$50	$8.6M
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.	15,460	$310	$4.7M
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	47,520	$80	$3.9M
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	107,170	$30	$3.2M
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…	53,770	$50	$2.7M
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	64,960	$40	$2.3M

Showing 1–10 of 336

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Louisiana Distribution

Children's Hospital — 13 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Louisiana

Full comparison — all codes billed, vs. Louisiana median

336 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	33	270	9,980	$110	$2.6M
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.	68	240	4,030	$130	$2M
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.	3	270	11,250	$90	$1.8M
82261	The lab analyst performs a measurement of the enzyme biotinidase, typically on a blood sample. This enzyme test is useful for the identification of a deficiency of biotinidase and also for the…	2	10	111,790	$10	$1.6M
83789	The lab analyst performs the technical lab test to evaluate the specimen for the presence or amount of a nondrug analyte by using mass spectrometry and tandem mass spectrometry.	3	10	450	$20	$1.2M
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	22	70	620	$230	$913.4K
96910	The provider applies tar or petrolatum to the skin and exposes the area to ultraviolet B, or UVB, rays to treat certain skin diseases such as psoriasis.	4	10	310	$30	$747.3K
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	6	60	1,160	$280	$690.6K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	19	100	620	$40	$560K
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…	18	30	2,260	$110	$460.1K

Showing 1–10 of 336

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Hospital	LA	Specialist	$0	$24.4M
Tere Vives	LA	Ophthalmology Physician	$25.2K	$412K
Gordon Myers	OH	Allergy & Immunology Physician	$251.2K	$0
Amaya Basta	OH	Diagnostic Radiology Physician	$132.9K	$0
Vahe Zohrabian	OH	Diagnostic Radiology Physician	$106.7K	$24.2K
Vincent Devlin	CA	Allergy & Immunology Physician	$119.3K	$0
Lindsay Hymel	LA	Emergency Medicine Physician	$62.8K	$0
Clinton Davidson	KY	Diagnostic Radiology Physician	$54.9K	$0
Arthur Zieske	TX	Anatomic Pathology & Clinical Pathology Physician	$46.1K	$0
Heather Cleveland	CO	Surgical Physician Assistant	$28.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Louisiana State University School Of Med In New Orleans Faculty Grou	LA	Pediatrics Physician	$0	$43M
Childrens Hospital Medical Practice Corporation	LA	Pediatrics Physician	$0	$33.2M
Marillac Community Health Centers	LA	Federally Qualified Health Center (FQHC)	$0	$24.2M
Children's Hospital	LA	Specialist	$0	$9.8M
Acadia Health, LLC	LA	General Practice Dentistry	$0	$9.6M
Jamie Yeager	LA	Student in an Organized Health Care Education/Training Program	$302.6K	$0
Cary Donohue	LA	Podiatrist	$119.3K	$122.4K
Leslee Mcnabb	LA	Diagnostic Radiology Physician	$195.6K	$0
Nathan Macaluso	LA	Physical Therapist	$114.1K	$0
Felix Savoie	LA	Sports Medicine (Orthopaedic Surgery) Physician	$95.1K	$0

Children's Hospital — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References