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

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

Arkansas Childrens Northwest, Inc. (NPI 1255875746)

Field	Value
Entity Type	Organization
Organization	Arkansas Childrens Northwest, Inc.
Address	2601 South 56th Street
City	Springdale
State	AR
ZIP	72762
Taxonomy	Children's Hospital
NPI Enumerated	December 19, 2016

Payer Source	Total Paid
Medicaid	$48M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-focused institution: there is no Medicare billing on file and reported lifetime Medicaid revenue is $48M. The NPI was enumerated 2016-12-19 (~10 years ago), indicating roughly a decade of recorded activity under this identifier.

Revenue is highly concentrated in a small set of lab and clinic codes: the top 3 Medicaid codes (87633, 87798, T1015) account for 52.2% of the provider’s total Medicaid revenue. Those three codes individually generate $13.6M (87633, 34.6%), $4M (87798, 10.3%), and $2.8M (T1015, 7.3%), signaling reliance on a few high-volume services.

The code mix points to a pediatric hospital with a large centralized laboratory and high outpatient clinic throughput: multiple high-revenue entries are molecular infectious-disease tests (87633, 87798, 87581, 87486, 87651) alongside clinic visit code T1015 and common pediatric procedures. Large claim counts such as 55.8K claims for 87633 and 189.9K claims for T1015 reinforce that diagnostic testing and clinic encounters are core operational drivers.

On competitive standing, the provider is a statewide leader for several infectious-disease test codes: 87633, 87798, 87581, and 87486 each rank #1 in-state and are labeled “extreme outlier” or at the 100th percentile, indicating volumes far above typical Arkansas peers for these tests. Additional lab codes such as 84145 rank #2 of 35 (97th percentile), which together suggest this site functions as a major pediatric testing hub in Arkansas.

Beyond lab testing, the provider reports meaningful imaging and procedural revenue consistent with a full-service children’s hospital: 70551 (MRI brain, $1.8M) ranks #3 of 41 (95th percentile), 93306 (echocardiography, $958.4K) and 70450 (CT head, $736.8K) appear in the top codes, and surgical ENT codes like 42820 (tonsil/adenoid, $586.9K) and 69436 (tympanostomy, $388K) also contribute. These entries indicate in‑house advanced imaging and operative capability in addition to high-volume laboratory services.

There is also a presence of specialty and therapeutic services beyond diagnostics: J0585 (onabotulinumtoxina injections) generates $1M (rank #3 of 6, 60th percentile) and codes for therapy and infusions such as 97110 and 96365 together contribute additional outpatient procedural revenue. While these are smaller shares of total Medicaid revenue, they demonstrate service diversification outside laboratory testing.

Volume metrics emphasize high throughput: several lab codes show large claim counts (e.g., 55.8K claims for 87633, 55.9K for 87798, 55.7K for 87581 and 87486), which, combined with the 189.9K claims for T1015, imply substantial patient encounters or centralized lab billing practices. Clinic volume for T1015 ranks #22 of 532 providers in-state (96th percentile), indicating robust ambulatory activity even relative to a broad statewide peer group.

The concentration risk is notable: with the top 3 Medicaid codes accounting for 52.2% of Medicaid revenue, the provider’s financial profile is sensitive to shifts in utilization or reimbursement for a small set of lab/clinic services. At the same time, presence of imaging, procedures, and therapeutic codes provides some revenue diversification that could mitigate sole dependence on the dominant molecular test codes.

Medicaid: Complete Services Breakdown

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

258 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	55,790	$240	$13.6M
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	55,880	$70	$4M
T1015	Clinic visit/encounter, all-inclusive	189,890	$20	$2.8M
0241U	N/A	15,120	$160	$2.3M
87581	The lab analyst performs a test for Mycoplasma pneumonia, a bacteria, using amplified nucleic acid probe technique.	55,740	$40	$2.3M
87486	The lab analyst performs a test for Chlamydia pneumoniae using amplified nucleic acid probe technique. Chlamydia pneumoniae also known as TWAR, Taiwan Acute Respiratory agent, commonly causes mild…	55,720	$40	$2.3M
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.	3,210	$550	$1.8M
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	19,580	$60	$1.2M
J0585	Injection, onabotulinumtoxina, 1 unit	280	$3,690	$1M
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	3,180	$300	$958.4K

Showing 1–10 of 258

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Arkansas Distribution

Arkansas Childrens Northwest, Inc. — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arkansas

Full comparison — all codes billed, vs. Arkansas median

258 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	22	530	4,960	$70	$2.6M
J0585	Injection, onabotulinumtoxina, 1 unit	3	10	280	$1,420	$2.1M
E0445	Oximeter device for measuring blood oxygen levels non-invasively	5	10	780	$310	$1.9M
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…	1	30	290	$240	$857.7K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	253	570	2,470	$70	$801.4K
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…	4	10	2,950	$110	$730.6K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	517	580	3,620	$60	$712.7K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	170	500	3,410	$60	$523.5K
0241U	N/A	2	40	1,640	$120	$370.5K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	4	30	80	$600	$290.7K

Showing 1–10 of 258

Related Providers

Other providers that share a Tax Identification Number (TIN) with Arkansas Childrens Northwest, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prisma Health Medical Group-midlands	SC	Orthopaedic Surgery Physician	$0	$8.7M
Melissa Magill	GA	Pediatrics Physician	$0	$377.8K
Nicole Massoll	AR	Anatomic Pathology & Clinical Pathology Physician	$347.3K	$0
Robert Baker	AR	Pediatric Anesthesiology Physician	$330.8K	$0
Kyle Arthur	AR	Sports Medicine (Family Medicine) Physician	$141.3K	$2.2K
Wesley Cox	AR	Orthopaedic Surgery Physician	$122.9K	$0
Lawrence O'malley	AR	Orthopaedic Surgery Physician	$109.6K	$0
Robert Martin	AR	Orthopaedic Foot and Ankle Surgery Physician	$108.4K	$0
Roni Cox	AR	Anatomic Pathology & Clinical Pathology Physician	$85.3K	$0
Rodolfo Henrich Lobo	AR	Anatomic Pathology & Clinical Pathology Physician	$82.1K	$0

Nearby Providers

Other providers in the same ZIP code as Arkansas Childrens Northwest, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ozark Guidance Center, Inc	AR	Community/Behavioral Health Agency	$0	$74.5M
Arisa Health, Inc.	AR	Community/Behavioral Health Agency	$0	$14.9M
Jarvis Pediatric Therapy, Inc.	AR	Specialist	$0	$10.6M
Wendy Cassady Speech Pathology, Inc	AR	Speech-Language Pathologist	$0	$9.2M
Preferred Family Healthcare Inc	AR	Community/Behavioral Health Agency	$0	$8.1M
Kidscorp Of Fayetteville, Inc	AR	Developmental Disabilities Clinic/Center	$0	$6.9M
University Of Arkansas For Medical Sciences	AR	Developmental - Behavioral Pediatrics Physician	$0	$5.8M
Northwest Physicians LLC	AR	Obstetrics Physician	$0	$5.8M
Highlands Oncology Group PA	AR	Hematology & Oncology Physician	$0	$5.7M
All Aboard Pediatric Therapy	AR	Pediatric Occupational Therapist	$0	$5.3M

Arkansas Childrens Northwest, Inc. — Billing Profile & Reimbursement Data

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Arkansas Childrens Northwest, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References