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

Why is the Medicaid comparison limited to California 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. California (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.

Childrens Hospital Of Los Angeles (NPI 1124073366)

Field	Value
Entity Type	Organization
Organization	Childrens Hospital Of Los Angeles
Address	4650 W Sunset Blvd
City	Los Angeles
State	CA
ZIP	90027
Taxonomy	Children's Hospital
NPI Enumerated	May 24, 2006

Payer Source	Total Paid
Medicaid	$137M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-focused facility: there is no Medicare billing on file and total Medicaid revenue is $137M, so the organization's public-payor footprint is dominated by Medicaid rather than a dual Medicare/Medicaid mix. The NPI was enumerated on 2006-05-24 (~20 years ago), indicating a long-tenured presence in the market but with current reported billing concentrated in Medicaid. The absence of Medicare activity means any competitive or utilization analysis should center on Medicaid-coded services and in-state peer comparisons.

Revenue concentration is high: the precomputed top three Medicaid codes account for 48.4% of the provider’s total Medicaid revenue, signaling near-half dependence on a small set of service lines. The three top revenue codes are 0123 ($21.9M, 3.2K claims, $6939 avg paid/claim), 0450 ($11.9M, 216.3K claims, $55 avg paid/claim), and Z7500 ($8.7M, 256.3K claims, $34 avg paid/claim); this mix creates a concentration profile where a few codes meaningfully drive overall Medicaid dollars.

Top-code business implications point to a pediatric tertiary/diagnostic hospital profile: while 0123, 0450, and Z7500 lack descriptions in the file, the broader code mix includes high-volume and high-acuity diagnostic and therapeutic services such as 70553 (MRI brain without/with contrast; $6.8M revenue, 8.1K claims, $834 avg paid/claim), 70551 (MRI brain without contrast; $3.1M, 7.5K claims, $413 avg), and pediatric sleep testing 95782 (attended sleep study for patients under age 6; $2.5M, 3K claims, $851 avg). Together, the presence of multiple MRI and pediatric sleep-study codes, transfusion product P9016 ($1.6M, 3K claims, $530 avg), and large lab volumes suggests substantial imaging, diagnostic, and inpatient/support services consistent with a children’s hospital.

Several individual codes show dominant in-state positions and labeled outlier behavior: 0123 ranks #1 of 16 providers in-state (100th percentile; notably above typical state volume), Z7500 ranks #1 of 181 providers (100th percentile; extreme outlier), and P9016 ranks #1 of 78 providers (100th percentile; extreme outlier). These rank/percentile results indicate that for multiple high-revenue codes this provider is the primary performer in California pediatric Medicaid billing and, for those codes, a market leader within the state.

Volume-driven low-unit-price codes also play a meaningful role: codes such as 0515 (125.7K claims, $11 avg paid/claim, $1.4M revenue), Z7610 (103.2K claims, $12 avg paid/claim, $1.2M revenue), and 80053 (104K claims, $12 avg paid/claim, $1.2M revenue) generate sizable aggregate revenue through very high claim counts. These entries suggest the facility handles large outpatient/ambulatory throughput and routine panels or administrative encounters that, while low-paid per claim, cumulatively support overall Medicaid revenue.

Diagnostic testing and infectious-disease services are material contributors: U0003 (COVID PCR) shows 25.4K claims at $77 avg paid/claim for $2M in revenue (rank #66 of 751 in-state, 91st percentile), and other lab codes such as 87799 and 87633 each contribute roughly $1.1M. The combination of pandemic-era high-throughput molecular testing plus standard lab panels indicates robust laboratory capacity and significant reliance on high-volume lab services in the Medicaid mix.

Operational and revenue-per-encounter profile favors high-cost diagnostics: several high-revenue, high-average-paid codes reflect expensive imaging and specialized testing—70553 at $834 avg paid/claim and 95782 at $851 avg paid/claim—so shifts in imaging or sleep-study volumes could materially affect revenue. Conversely, a large share of revenue also comes from high-claim, low-unit-value codes, indicating sensitivity to changes in visit volume or outpatient throughput as well as to Medicaid reimbursement rates for low-unit services.

From a competitive-risk perspective, the provider’s state-level dominance on multiple pediatric-focused codes (many at the 100th percentile or near it) underscores defensible specialty volume in California Medicaid. However, the high concentration of revenue in the top three Medicaid codes (48.4% of Medicaid revenue) also creates exposure: if utilization patterns, coding, or reimbursement for those concentrated codes change, the provider’s Medicaid revenue base could be significantly affected.

Medicaid: Complete Services Breakdown

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

602 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
0123	N/A	3,160	$6,940	$21.9M
0450	N/A	216,290	$60	$11.9M
Z7500	N/A	256,280	$30	$8.7M
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	8,140	$830	$6.8M
Z6020	N/A	19,920	$260	$5.2M
0636	N/A	7,820	$470	$3.7M
70551	The provider uses magnetic resonance imaging, or MRI, to examine the brain and brain stem. The provider does not administer contrast for this exam.	7,480	$410	$3.1M
Z4300	N/A	29,440	$100	$3M
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	2,970	$850	$2.5M
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…	25,420	$80	$2M

Showing 1–10 of 602

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. California Distribution

Childrens Hospital Of Los Angeles — 15 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. California median

602 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0390	Trauma response team associated with hospital critical care service	7	10	250	$8,790	$6.1M
Z6020	N/A	1	10	19,920	$260	$5.2M
0450	N/A	9	450	16,140	$90	$3.6M
Z5999	N/A	16	20	3,330	$380	$2M
0123	N/A	1	20	130	$3,160	$1.9M
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	250	390	1,270	$220	$1.5M
81479	Use 81479 to report a molecular pathology procedure that does not have a specific code.	44	50	500	$160	$1.1M
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.	574	1,570	680	$110	$1.1M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	18	40	200	$1,990	$1M
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.	990	1,300	510	$100	$943K

Showing 1–10 of 602

Related Providers

Other providers that share a Tax Identification Number (TIN) with Childrens Hospital Of Los Angeles, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Hospital Los Angeles Medical Group, Inc.	CA	Multi-Specialty Clinic/Center	$0	$24.6M
Joe Pastrano	CA	Diagnostic Radiology Physician	$269.1K	$0
Shaheen Umar	WA	Neuroradiology Physician	$82.9K	$137.1K
Tadesse Eshetu	KY	Neuroradiology Physician	$202.5K	$0
Daniel Susanto	WA	Neuroradiology Physician	$173.4K	$0
David Lee	CA	Diagnostic Radiology Physician	$141K	$0
Nathan Mortensen	CA	Diagnostic Radiology Physician	$109.4K	$0
Jim Kim	CA	Transplant Surgery Physician	$101.3K	$0
Quin Liu	CA	Pediatric Gastroenterology Physician	$100K	$0
Daniel Allison	CA	Orthopaedic Surgery Physician	$97.3K	$0

Nearby Providers

Other providers in the same ZIP code as Childrens Hospital Of Los Angeles, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Altamed Health Services Corp.	CA	Federally Qualified Health Center (FQHC)	$0	$305.5M
Kaiser Foundation Hospitals	CA	General Acute Care Hospital	$0	$66.4M
Asian Pacific Health Care Venture, Inc.	CA	Community Health Clinic/Center	$0	$54M
Southern California Permanente Medical Group	CA	Health Maintenance Organization	$0	$48.2M
Los Angeles County Department Of Mental Health	CA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$45.3M
Kaiser Foundation Hospitals	CA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$27.4M
Ovik Avetisyan	CA	Durable Medical Equipment & Medical Supplies	$0	$23.8M
Lance Chapman	CA	MOHS-Micrographic Surgery Physician	$1.4M	$0
Vincent Bennett	CA	Emergency Medicine Physician	$1.2M	$0
Rafayel Gevorkian	CA	Adolescent Medicine (Internal Medicine) Physician	$589K	$139.8K

Childrens Hospital Of Los Angeles — Billing Profile & Reimbursement Data

Sign up for Childrens Hospital Of Los Angeles — Billing Profile & Reimbursement Data policy alerts

Childrens Hospital Of Los Angeles — Billing Profile & Reimbursement Data

Sign up for Childrens Hospital Of Los Angeles — Billing Profile & Reimbursement Data policy alerts

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