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

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

Ssm Cardinal Glennon Children's Hospital (NPI 1508935891)

Field	Value
Entity Type	Organization
Organization	Ssm Cardinal Glennon Children's Hospital
Address	1465 S Grand Blvd
City	Saint Louis
State	MO
ZIP	63104
Taxonomy	Children's Hospital
NPI Enumerated	November 8, 2006

Payer Source	Total Paid
Medicaid	$52.6M
Medicare	$0

Key Findings

SSM CARDINAL GLENNON CHILDREN'S HOSPITAL is effectively a single-payer Medicaid provider in the available data: there is no Medicare billing on file while total Medicaid revenue is $52.6M. Its NPI was enumerated on 2006-11-08 (~20 years ago), indicating an established presence in the market and long-term participation in Medicaid networks.

Revenue is highly concentrated in a few outpatient and emergency-related codes: the top three Medicaid codes (G0463, 99283, X4011) together account for 62.5% of this provider's total Medicaid revenue. Those top-line contributions are G0463 $11.9M (24.3%), 99283 $10.7M (21.9%), and X4011 $7.9M (16.3%), which shows reliance on a small set of high-volume services to drive Medicaid dollars.

Clinical and business operations appear focused on pediatric emergency and outpatient clinic care. G0463 (88.6K claims, $11.9M revenue) is the single largest revenue contributor and alongside very large volumes for 99283 (48.8K claims, $10.7M) and 99282 (32.9K claims, $4.1M) indicates a high-throughput emergency/urgent care function supporting much of the hospital's Medicaid revenue.

The provider is a major statewide player for several ED-related codes: 99283 ranks #8 of 1263 providers in-state (99th percentile; extreme outlier, far above typical state volume for this code) and 99282 ranks #1 of 495 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code). X4011 also ranks highly at #3 of 106 providers in-state (98th percentile; notably above typical state volume for this code), while G0463 ranks #8 of 96 providers in-state (93th percentile; typical, unremarkable volume for this code); collectively these standings point to a dominant regional role in Medicaid pediatric ED/outpatient care.

Beyond ED and clinic visits, the claims mix shows substantial in-house diagnostics and ambulatory support services that align with a pediatric hospital model. High-volume lab and test codes include 87804 ($909.3K, 1.9%), 87880 ($503.3K, 1.0%), 85025 ($594.9K, 1.2%), 93005 ($489.9K, 1.0%), and 94010 ($286.2K, 0.6%), reflecting integrated laboratory, respiratory, and cardiac diagnostic capacity to support acute and outpatient pediatrics.

Procedure-level billing indicates routine pediatric surgical and procedural activity in ENT and related specialties: 42820 (tonsil/adenoid removal) has 122 claims and $565.3K revenue (1.2%, ranks #15 of 34 in-state, 58th percentile) and 69436 (tympanostomy with tube) has 286 claims and $517.7K revenue (1.1%, ranks #18 of 69 in-state, 75th percentile). These items, while smaller revenue shares, confirm a mix that includes ambulatory surgical throughput in addition to emergency care.

Per-claim payment patterns highlight a mix of higher-acuity services and specialized billings that increase revenue per encounter: codes with elevated average paid-per-claim include X4006 ($3264 avg paid/claim, $421.1K revenue), Y7506 ($667 avg paid/claim, $424.9K revenue), 88300 ($1073 avg paid/claim, $340.1K revenue), and 99285 ($560 avg paid/claim, $369K revenue). Together these suggest the hospital bills for both higher-acuity ED care and specialized diagnostic/pathology services that contribute meaningful margins on a per-claim basis.

Taken together, the profile shows a long-tenured pediatric hospital that derives the bulk of its reported Medicaid revenue from high-volume outpatient clinic and emergency evaluation-and-management services, with supportive diagnostic, procedural, and surgical lines. The combination of $52.6M in Medicaid revenue, a 62.5% concentration in three codes, and multiple extreme outlier rankings state-wide signals a regional referral and high-throughput role in pediatric Medicaid care rather than a general, low-volume outpatient practice.

Medicaid: Complete Services Breakdown

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

178 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	88,640	$130	$11.9M
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.	48,780	$220	$10.7M
X4011	N/A	38,370	$210	$7.9M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	32,890	$130	$4.1M
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.	10,500	$310	$3.3M
X4003	N/A	28,980	$60	$1.7M
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	4,250	$210	$909.3K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	18,850	$50	$904.7K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	10,080	$60	$594.9K
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…	16,200	$40	$583.1K

Showing 1–10 of 178

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

Ssm Cardinal Glennon Children's Hospital — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

178 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
X4011	N/A	3	110	5,700	$340	$3.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	8	100	2,240	$80	$2.2M
Y7506	N/A	60	100	980	$250	$1.6M
X4003	N/A	8	70	1,480	$80	$1.1M
X4006	N/A	35	50	370	$780	$969.5K
Y7507	N/A	45	50	270	$360	$594.9K
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…	20	30	80	$120	$440.4K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	90	90	1,850	$120	$384.1K
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.	168	600	140	$170	$384.1K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	53	110	2,100	$70	$364.3K

Showing 1–10 of 178

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ssm Medical Group, Inc.	MO	Multi-Specialty Clinic/Center	$0	$19.4M
Ssm Cardinal Glennon Childrens Hospital	IL	Pediatrics Physician	$0	$5.4M
Rotimi Johnson	IL	Vascular & Interventional Radiology Physician	$624.3K	$1.1K
Shamseldeen Mahmoud	MO	Neuroradiology Physician	$109.5K	$474K
Yihua Zhou	MO	Diagnostic Radiology Physician	$119.1K	$387.3K
Emad Allam	IL	Diagnostic Radiology Physician	$43.9K	$291.2K
Daniel Davignon	AK	Diagnostic Radiology Physician	$248.8K	$21.1K
Ece Akduman	MO	Diagnostic Radiology Physician	$59.6K	$169.5K
Eugene Evra	MO	Physical Medicine & Rehabilitation Physician	$224K	$2.3K
Shaheen Umar	WA	Neuroradiology Physician	$82.9K	$137.1K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ssm-sluh Inc	MO	General Acute Care Hospital	$0	$20.6M
Ssm Health Care Group	MO	Internal Medicine Physician	$0	$17.3M
Levent Akduman	MO	Ophthalmology Physician	$3.1M	$1.4M
Affinia Healthcare	MO	Federally Qualified Health Center (FQHC)	$0	$4.2M
Southside Wellness Center Inc	MO	Personal Care Attendant	$0	$3.8M
Kristin Smith	MO	Dermatopathology Physician	$451.5K	$12.4K
Nicole Burkemper	MO	Dermatology Physician	$237K	$51.7K
M Yadira Hurley	MO	Dermatopathology Physician	$242K	$38.4K
Abdalla Hassan	MO	Interventional Cardiology Physician	$244K	$8.1K
Gillian Heinecke	MO	Dermatology Physician	$226.9K	$8K

Ssm Cardinal Glennon Children's Hospital — Billing Profile & Reimbursement Data

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Ssm Cardinal Glennon Children's Hospital — 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