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.

Childrens Emergency Services Inc (NPI 1306904503)

Field	Value
Entity Type	Organization
Organization	Childrens Emergency Services Inc
Address	1 Childrens Plz
City	Dayton
State	OH
ZIP	45404
Taxonomy	Pediatric Emergency Medicine (Emergency Medicine) Physician
NPI Enumerated	December 4, 2006

Payer Source	Total Paid
Medicaid	$8.7M
Medicare	$0

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	81,790	$60	$4.7M
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.	67,930	$30	$2.3M
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.	20,020	$90	$1.7M
99292	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	40	$140	$5K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	50	$70	$3.4K
69209	The provider flushes or washes (irrigation/lavage) out the entrapped wax (cerumen) from a patient’s external ear canal with a stream of water to correct hearing loss or discomfort.	130	$1	$130
99053	The provider renders overnight services at a 24 hour facility.	3,930	$0	$0

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

Childrens Emergency Services Inc — 1 of 6 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

7 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.	40	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.	33	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.	96	580	510	$100	$1.3M
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	212	260	280	$50	$120.1K
99292	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	14	20	40	$30	$13K
69209	The provider flushes or washes (irrigation/lavage) out the entrapped wax (cerumen) from a patient’s external ear canal with a stream of water to correct hearing loss or discomfort.	10	30	50	$1	$1.8K
99053	The provider renders overnight services at a 24 hour facility.	9	70	410	$1	$20

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dayton Children's Hospital	OH	Children's Hospital	$0	$290.6M
Dayton Children's Specialty Physicians, Inc.	OH	Pediatrics Physician	$0	$31.8M
Laura Tully	OH	Otolaryngology Physician	$94.6K	$0
David Gooden	OH	Anesthesiology Physician	$19.1K	$0

Childrens Emergency Services Inc — Billing Profile & Reimbursement Data

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Childrens Emergency Services 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

Nearby Providers

Frequently Asked Questions

References