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

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

Dayton Children's Specialty Physicians, Inc. (NPI 1225192610)

Dayton Children's Specialty Physicians, Inc. is a pediatrics physician provider located in Dayton, Ohio. This profile covers 0 Medicare and 136 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	Dayton Children's Specialty Physicians, Inc.
Address	1 Childrens Plz
City	Dayton
State	OH
ZIP	45404
Taxonomy	Pediatrics Physician
NPI Enumerated	December 20, 2006

Payer Source	Total Paid
Medicaid	$31.8M
Medicare	$0

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

136 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	136,960	$40	$5.5M
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.	90,110	$60	$5M
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…	128,910	$30	$3.4M
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.	98,330	$30	$3.1M
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…	37,990	$50	$1.9M
00170	The provider performs anesthesia services for a patient undergoing an intraoral procedure, including biopsy.	25,310	$70	$1.7M
99203	The provider sees a new 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 provider…	42,480	$30	$1.3M
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…	17,220	$50	$929.9K
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.	45,860	$20	$825.4K
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.	7,190	$90	$618.3K

Showing 1–10 of 136

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Ohio Distribution

Dayton Children's Specialty Physicians, Inc. — 14 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

136 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	24	480	4,510	$90	$1.8M
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.	26	660	460	$90	$1.5M
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.	167	580	510	$100	$1.3M
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.	7	10	480	$290	$1.2M
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	8	80	100	$860	$719.1K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	7	40	100	$850	$680.6K
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.	4	230	2,200	$100	$530.1K
U0004	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…	33	40	230	$130	$455.9K
42830	The provider performs an initial adenoidectomy in a patient who is less than 12 years old.	5	20	220	$940	$433.3K
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…	8	30	620	$130	$428.2K

Showing 1–10 of 136

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pediatric Academic Association, Inc.	OH	Pediatrics Physician	$0	$37.2M
Lester E Cox Medical Centers	MO	Family Medicine Physician	$0	$17M
Bruce Buerk	OH	Retina Specialist (Ophthalmology) Physician	$3.4M	$0
Scott Schoenberger	OH	Retina Specialist (Ophthalmology) Physician	$2.1M	$0
Martin Wilkes	OH	Retina Specialist (Ophthalmology) Physician	$2.1M	$0
Laura Tully	OH	Otolaryngology Physician	$94.6K	$0
Ron Johnson	OH	Plastic and Reconstructive Surgery Physician	$34.5K	$0
David Gooden	OH	Anesthesiology Physician	$19.1K	$0
Hilary Williamson	OH	Physician Assistant	$9.1K	$0
Mary Mcgregor	OH	Ophthalmology Physician	$8.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dayton Children's Hospital	OH	Children's Hospital	$0	$290.6M
Childrens Emergency Services Inc	OH	Pediatric Emergency Medicine (Emergency Medicine) Physician	$0	$8.7M

Dayton Children's Specialty Physicians, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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