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

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

Shield - Denver Health Care Center, Inc. (NPI 1124132154)

Field	Value
Entity Type	Organization
Organization	Shield - Denver Health Care Center, Inc.
Address	847 N Church Ct
City	Elmhurst
State	IL
ZIP	60126
Taxonomy	Parenteral & Enteral Nutrition Supplies (DME)
NPI Enumerated	August 18, 2006

Payer Source	Total Paid
Medicaid	$100.7M
Medicare	$0

Key Findings

SHIELD - DENVER HEALTH CARE CENTER, INC. is effectively a single-payer Medicaid DME supplier: there is no Medicare billing on file while reported Medicaid lifetime revenue totals $100.7M. This billing footprint indicates the business is focused almost entirely on Medicaid-covered durable medical and enteral/nutrition supplies rather than Medicare fee-for-service channels.

Revenue concentration is meaningful: the top three Medicaid codes by revenue account for 34.0% of the provider's total Medicaid revenue. This indicates a reliance on a relatively small set of high-volume product lines — primarily disposable incontinence products and enteral nutrition supplies — to generate a large share of overall Medicaid payments.

The provider’s code mix and high-volume codes point to an operational focus on incontinence supplies and enteral feeding. Leading codes include T4541 (underpad, large), T4527/T4526 (protective underwear/pull-on, large and medium), and multiple enteral formula and supply codes such as B4035 and B4160/B4161, which together suggest the operation fills recurring consumable needs (disposables and enteral formula) rather than episodic durable devices.

SHIELD is a dominant statewide supplier for several incontinence product codes: T4541 is listed as an extreme outlier and ranks #2 of 132 providers in-state (99th percentile), while T4527 and T4526 both rank #2 statewide (99th percentile) and are described as notably above typical state volume. These high ranks and percentile positions indicate the provider is a major competitor in Illinois for adult incontinence disposables.

For enteral nutrition, the provider shows above-typical to top-in-state volume on multiple codes. B4160 ranks #1 of 17 providers in-state (100th percentile) and B4161 and B4035 rank #3 in their peer groups (87th and 93th percentiles respectively), indicating SHIELD is a significant supplier of pediatric and pump-fed enteral nutrition products in the state. This combination of top ranks across both incontinence and enteral lines suggests a broad DME consumables business rather than a narrow niche.

Many Medicaid codes show very high claim volumes as well as high percentile rankings for this provider: examples include A4927 (gloves) at 200.8K claims and T4535 (disposable liner) at 171.4K claims, both ranking in the 99th or very high percentiles. These large claim counts for low-unit-price consumables reinforce a business model built on high-frequency supply distribution to Medicaid beneficiaries.

The provider’s NPI was enumerated around 2006-08-18 (about ~20 years ago), signaling a long tenure in the market. This longevity, combined with repeated top-state rankings across multiple codes, supports the view that SHIELD has established distribution relationships and operational capacity to sustain high volumes of recurring DME supplies.

While SHIELD ranks at or near the top statewide for many codes, not all high-revenue codes are extreme outliers; several enteral and catheter codes are characterized as typical or unremarkable volumes (for example, B4035 and A4353 rank in the 93th and 89th percentiles respectively). This mix indicates that while SHIELD dominates certain categories (especially adult incontinence disposables), it participates more modestly or competitively in other DME segments.

Medicaid: Complete Services Breakdown

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

92 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T4541	Incontinence product, disposable underpad, large, each	268,800	$60	$16.1M
T4527	Adult sized disposable incontinence product, protective underwear/pull-on, large size, each	79,420	$100	$8.3M
T4526	Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each	71,140	$110	$7.5M
T4535	Disposable liner/shield/guard/pad/undergarment, for incontinence, each	171,420	$40	$7.2M
T4528	Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each	49,820	$130	$6.3M
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	23,640	$250	$5.9M
B4161	Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding…	7,820	$670	$5.2M
A4353	Intermittent urinary catheter, with insertion supplies	6,040	$780	$4.7M
B4160	Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals,…	17,600	$250	$4.3M
T4544	Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each	20,970	$190	$4M

Showing 1–10 of 92

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Illinois Distribution

Shield - Denver Health Care Center, Inc. — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Illinois

Full comparison — all codes billed, vs. Illinois median

92 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
B4161	Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding…	3	20	1,330	$590	$1.8M
A4353	Intermittent urinary catheter, with insertion supplies	2	10	1,690	$650	$1.8M
A6197	Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing	3	10	1,250	$220	$1.6M
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	3	30	2,590	$110	$1.4M
T4534	Youth sized disposable incontinence product, protective underwear/pull-on, each	3	10	1,060	$70	$1.3M
B4160	Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals,…	1	20	2,110	$220	$915.7K
A6210	Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing	4	10	2,980	$150	$786.3K
B4149	Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral…	4	10	760	$290	$783K
T4524	Adult sized disposable incontinence product, brief/diaper, extra large, each	2	20	870	$70	$775.9K
T4527	Adult sized disposable incontinence product, protective underwear/pull-on, large size, each	2	90	1,400	$80	$727.1K

Showing 1–10 of 92

Nearby Providers

Other providers in the same ZIP code as Shield - Denver Health Care Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Superior Air-ground Ambulance Service, Inc	IL	Land Ambulance	$16.1M	$90.5M
Rehabtech Supply, LLC	IL	Durable Medical Equipment & Medical Supplies	$0	$89M
Home Medical Express Inc.	IL	Oxygen Equipment & Supplies (DME)	$0	$22M
Trilab, LLC	IL	Clinical Medical Laboratory	$718K	$19.3M
Total Spectrum, LLC	IL	Behavior Analyst	$0	$8.5M
Alvaro Candel	IL	Anatomic Pathology & Clinical Pathology Physician	$61.8K	$6.4M
Saad Ahmad	IL	Ophthalmology Physician	$3.3M	$2.4M
Mohamed Adenwalla	IL	Ophthalmology Physician	$2.3M	$2.4M
Aaron Weinberg	IL	Retina Specialist (Ophthalmology) Physician	$3.3M	$1.2M
Kevin Patel	IL	Ophthalmology Physician	$2.3M	$589K

Shield - Denver Health Care Center, Inc. — 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

Nearby Providers

Frequently Asked Questions

References