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

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

Nemours Children's Health, Jacksonville, Specialty Care (NPI 1437720414)

Field	Value
Entity Type	Organization
Organization	Nemours Children's Health, Jacksonville, Specialty Care
Address	807 Childrens Way
City	Jacksonville
State	FL
ZIP	32207
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	July 9, 2021

Payer Source	Total Paid
Medicaid	$23.6M
Medicare	$0

Medicaid: Complete Services Breakdown

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

149 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…	33,780	$100	$3.5M
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…	11,160	$220	$2.4M
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…	33,560	$70	$2.3M
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…	13,920	$140	$1.9M
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…	12,460	$90	$1.1M
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	3,930	$270	$1.1M
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.	5,040	$180	$927.7K
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…	7,190	$110	$755.1K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	4,280	$160	$680.7K
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…	4,140	$160	$674.2K

Showing 1–10 of 149

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Florida Distribution

Nemours Children's Health, Jacksonville, Specialty Care — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Florida

Full comparison — all codes billed, vs. Florida median

149 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.	587	700	2,400	$80	$1.2M
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.	595	740	2,180	$70	$1.1M
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	18	30	310	$720	$616.3K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	10	60	100	$710	$379K
42830	The provider performs an initial adenoidectomy in a patient who is less than 12 years old.	30	40	120	$610	$357.5K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	15	80	230	$400	$331.4K
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…	1,651	2,250	1,250	$50	$324.4K
54161	The provider excises the foreskin of a patient older than 28 days; the provider uses a technique other than a clamp, other devices, or dorsal slit.	9	40	260	$580	$315.8K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	327	350	1,160	$80	$308.7K
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…	71	90	320	$180	$307.9K

Showing 1–10 of 149

Related Providers

Other providers that share a Tax Identification Number (TIN) with Nemours Children's Health, Jacksonville, Specialty Care, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Nemours Foundation	DE	Multi-Specialty Clinic/Center	$0	$172M
The Nemours Foundation	FL	Children's Hospital	$0	$104.9M
The Nemours Foundation	DE	Children's Hospital	$0	$104M
The Nemours Foundation	FL	Multi-Specialty Clinic/Center	$0	$46.2M
Nemours Children's Health, Downtown Orlando, Specialty Care	FL	Multi-Specialty Clinic/Center	$0	$44.4M
Sedigheh Ebadi	FL	Pediatrics Physician	$0	$10.1M
Children's Health Alliance, LLC	FL	Pediatrics Physician	$0	$9.6M
Michael Klufas	PA	Ophthalmology Physician	$7M	$0
Richard Kaiser	PA	Ophthalmology Physician	$6.6M	$0
Carl Regillo	PA	Ophthalmology Physician	$6.5M	$0

Nearby Providers

Other providers in the same ZIP code as Nemours Children's Health, Jacksonville, Specialty Care, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southern Baptist Hospital Of Florida Inc	FL	General Acute Care Hospital	$0	$88M
One Call Government Solutions, LLC	FL	Transportation Broker	$0	$48.5M
Emergency Physicians Inc	FL	Emergency Medicine Physician	$0	$34.2M
Southern Baptist Hospital Of Florida, Inc	FL	Children's Hospital	$0	$29.1M
Child Guidance Center, Inc.	FL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8M
Metro Treatment Of Florida, LP	FL	Methadone Clinic	$168.7K	$4.4M
Swl Services LLC	FL	Clinical Medical Laboratory	$4.1M	$2.5K
Gary Gabor	FL	Rheumatology Physician	$2.7M	$0
Bernhardt Laboratories Inc	FL	Clinical Medical Laboratory	$1.8M	$620.2K
Nicole Anderson	FL	Radiation Oncology Physician	$719.5K	$0

Nemours Children's Health, Jacksonville, Specialty Care — Billing Profile & Reimbursement Data

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Nemours Children's Health, Jacksonville, Specialty Care — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References