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.

Children's Hospital Medical Center (NPI 1366580391)

Field	Value
Entity Type	Organization
Organization	Children's Hospital Medical Center
Address	660 Lincoln Ave
City	Cincinnati
State	OH
ZIP	45206
Taxonomy	Durable Medical Equipment & Medical Supplies
NPI Enumerated	February 2, 2007

Payer Source	Total Paid
Medicaid	$51.1M
Medicare	$0

Key Findings

CHILDREN'S HOSPITAL MEDICAL CENTER is effectively a Medicaid-focused Durable Medical Equipment & Medical Supplies provider: there is no Medicare billing on file while lifetime Medicaid revenue is $51.1M, indicating this entity operates predominantly within the pediatric/child Medicaid market rather than as a Medicare DME supplier. The NPI was enumerated on 2007-02-02, meaning the provider has been registered for ~19 years, supporting an established presence in the state Medicaid channel.

Revenue concentration is significant: the precomputed top-three Medicaid codes account for 27.5% of the provider's total Medicaid revenue, indicating a concentrated revenue base where a small group of product lines (enteral formulas and supplies, and miscellaneous DME) drive a large share of receipts. That concentration suggests business sensitivity to utilization or reimbursement changes for those specific codes.

The provider shows a clear operational emphasis on pediatric enteral nutrition and feeding supplies. High-volume codes include B4161, B4035, B4160, B4034, and B4149 among others, with B4161 alone generating $3.9M (10.3% of Medicaid revenue) and B4035 generating $3.6M (9.6%). This mix indicates the organization supplies specialized pediatric enteral formulas and daily feeding kits at scale, consistent with a service model centered on long-term enteral nutrition management for children.

Competitive standing in-state is dominant for key supply categories: the provider ranks #1 in Ohio for B4161, B4035, B4160, B4034, and E0445 (each listed as 100th percentile or #1 of state peers), and is an extreme outlier for several feeding-supply codes. Those rankings reflect market leadership in pediatric enteral formulas and feeding kits within the state and suggest significant scale advantages versus local peers for these product lines.

There are multiple high-volume equipment and accessory lines beyond enteral nutrition: codes such as E1399 ($2.8M, 7.6%), E0465 ($2.1M, 5.7%), A4353 ($2.1M, 5.6%), and E0445 ($2.1M, 5.5%) indicate material business in miscellaneous DME, home ventilators, urinary catheters, and oximeters. E1399 ranks #2 in-state (96th percentile) and E0445 ranks #1 (100th percentile), highlighting that the provider’s offerings include both high-cost single items and high-volume daily-use supplies.

Several specific codes are flagged as extreme or notable outliers in state comparisons, underscoring atypically large volumes: B4035 and B4034 (feeding supply kits) are described as "extreme outlier" and rank #1 of their peer sets, while other enteral and oximetry codes are characterized as "notably above typical state volume." These descriptors point to operational focus and possibly specialized referral relationships or programmatic contracts that concentrate pediatric feeding and monitoring supply volume at this provider.

The absence of any Medicare billing means payer mix is effectively single-payer (Medicaid), concentrating reimbursement risk and operational dependence on state Medicaid program policy and pediatric enrollment dynamics. Analysts should treat reimbursement sensitivity and program changes to pediatric DME coverage as primary business risks and opportunities for this provider given its $51.1M Medicaid-only footprint.

While several DME categories are high-revenue, some items show typical or unremarkable volumes relative to peers (for example E0465 ranks in the 53th percentile, A4353 in the 40th percentile, and multiple wheelchair/accessory codes are mid-to-low percentile). This indicates that although the provider is a statewide leader in pediatric enteral supplies and certain monitoring devices, its market position is more modest across other DME subsegments, implying a focused rather than uniformly dominant service mix.

Medicaid: Complete Services Breakdown

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

139 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	15,560	$250	$3.9M
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	53,210	$70	$3.6M
E1399	Durable medical equipment, miscellaneous	4,550	$620	$2.8M
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,…	28,280	$100	$2.8M
B9998	Noc for enteral supplies	37,910	$60	$2.4M
B4149	Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral…	7,530	$300	$2.2M
E0465	Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)	2,460	$870	$2.1M
A4353	Intermittent urinary catheter, with insertion supplies	4,010	$520	$2.1M
E0445	Oximeter device for measuring blood oxygen levels non-invasively	8,450	$240	$2.1M
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	18,100	$90	$1.6M

Showing 1–10 of 139

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

Children's Hospital Medical Center — 9 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

139 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S9340	Home therapy; enteral nutrition; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded…	7	10	670	$580	$4.6M
A4353	Intermittent urinary catheter, with insertion supplies	4	10	4,740	$430	$3.4M
E0465	Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)	9	20	2,040	$590	$2.1M
E2609	Custom fabricated wheelchair seat cushion, any size	17	20	410	$830	$1.8M
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…	1	30	3,220	$390	$1.5M
A4409	Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each	4	10	2,690	$60	$1.3M
A4352	Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each	2	10	1,300	$330	$911.8K
A4385	Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each	5	10	940	$50	$830.5K
K0108	Wheelchair component or accessory, not otherwise specified	11	30	5,260	$160	$790.2K
A4425	Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each	5	10	1,530	$40	$765.5K

Showing 1–10 of 139

Related Providers

Other providers that share a Tax Identification Number (TIN) with Children's Hospital Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Hospital Medical Center	OH	Children's Hospital	$0	$386.8M
Children's Hospital Medical Center	OH	Pediatrics Physician	$0	$91.2M
Children's Hospital Medical Center	OH	Home Infusion Therapy Pharmacy	$0	$57M
Children's Hospital Medical Center	OH	Home Health Agency	$0	$19.2M
Children's Hospital Medical Center	OH	Pediatric Dentistry	$0	$11.6M
Robert Sisk	OH	Ophthalmology Physician	$2.5M	$0
William Hansen	OH	Counseling Psychologist	$112.8K	$194.9K
Roxana Rivera	OH	Ophthalmology Physician	$216K	$0
Mehran Attari	OH	Clinical Cardiac Electrophysiology Physician	$207K	$0
Joel Sorger	OH	Orthopaedic Surgery Physician	$193.5K	$0

Nearby Providers

Other providers in the same ZIP code as Children's Hospital Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Brightview, LLC	OH	Addiction Medicine (Internal Medicine) Physician	$2.3M	$501.1M
Greater Cincinnati Behavioral Health Services	OH	Community/Behavioral Health Agency	$0	$100.4M
Talbert House	OH	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$38M
Lighthouse Youth Services Inc.	OH	Mental Health Counselor	$0	$18.9M
Talbert House, Inc	OH	Substance Abuse Rehabilitation Facility	$0	$13.9M
First Step Home, Inc.	OH	Substance Abuse Rehabilitation Facility	$0	$9.9M
Emmanuel Rivera	OH	Geriatric Medicine (Family Medicine) Physician	$62.5K	$0

Children's Hospital Medical Center — 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