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 1306156138)

Children's Hospital is a specialist provider located in New Orleans, Louisiana. This profile covers 0 Medicare and 114 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	Children's Hospital
Address	200 Henry Clay Ave
City	New Orleans
State	LA
ZIP	70118
Taxonomy	Specialist
NPI Enumerated	October 14, 2010

Payer Source	Total Paid
Medicaid	$9.8M
Medicare	$0

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

114 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	19,770	$90	$1.8M
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…	25,580	$50	$1.4M
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…	23,020	$60	$1.3M
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…	32,190	$40	$1.2M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	6,520	$60	$404.2K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	7,480	$50	$403.8K
64642	The provider injects a chemical, such as Botox®, into one to four muscles of one extremity to relieve a patient's pain and spasms.	4,070	$90	$357.8K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	5,620	$50	$263.9K
64643	The provider injects a chemical, such as Botox®, into one to four muscles of an additional extremity after the first to relieve a patient's pain and spasms.	3,190	$80	$248.7K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	4,340	$40	$182.2K

Showing 1–10 of 114

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 — 12 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

114 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	9	10	630	$270	$927K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	82	90	1,270	$50	$375.3K
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…	130	2,890	980	$40	$246.8K
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…	171	3,230	1,120	$30	$204.3K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	58	160	380	$170	$194.7K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	143	470	560	$40	$157.3K
29705	The provider removes or modifies an existing cast covering an entire arm or leg when no longer required, needs replacement, or has become too tight due to excessive swelling.	2	10	150	$120	$140.2K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	220	750	760	$30	$135.9K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	71	660	1,070	$60	$129.3K
64642	The provider injects a chemical, such as Botox®, into one to four muscles of one extremity to relieve a patient's pain and spasms.	1	10	370	$130	$120.5K

Showing 1–10 of 114

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Childrens Hospital Of Wisconsin, Inc.	WI	Pediatrics Physician	$0	$19M
Adam Quinn	MS	Ophthalmology Physician	$620.3K	$0
Charles Richardson	MS	Ophthalmology Physician	$575.5K	$0
Todd Williamson	MS	Ophthalmology Physician	$543.8K	$0
Ted Harden	MS	Optometrist	$93.5K	$293.3K
Benjamin Pace	MS	Ophthalmology Physician	$259.9K	$0
Scott Paladichuk	MS	Optometrist	$62.2K	$98.4K
Sarah Queck	MS	Ophthalmology Physician	$83.5K	$260
George Ellis	LA	Pediatric Ophthalmology and Strabismus Specialist Physician Physician	$5K	$12.2K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Hospital	LA	Children's Hospital	$0	$150.9M
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
Children's Hospital	LA	Specialist	$0	$24.4M
Marillac Community Health Centers	LA	Federally Qualified Health Center (FQHC)	$0	$24.2M
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

Children's Hospital — Billing Profile & Reimbursement Data

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Children's Hospital — 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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