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.

Nationwide Children's Hospital Toledo, LLC (NPI 1588254650)

Field	Value
Entity Type	Organization
Organization	Nationwide Children's Hospital Toledo, LLC
Address	2213 Cherry St
City	Toledo
State	OH
ZIP	43608
Taxonomy	Children's Hospital
NPI Enumerated	January 22, 2021

Payer Source	Total Paid
Medicaid	$12.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

152 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	37,040	$110	$4.1M
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…	17,580	$70	$1.2M
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	5,150	$230	$1.2M
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	12,260	$80	$919.6K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	490	$1,380	$672.6K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	450	$990	$444.1K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	4,520	$80	$348K
G0378	Hospital observation service, per hour	3,160	$110	$344.7K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	4,400	$80	$330.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	3,030	$80	$248.8K

Showing 1–10 of 152

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

Nationwide Children's Hospital Toledo, LLC — 1 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

152 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	27	150	4,030	$100	$5.9M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	139	170	4,660	$300	$2.6M
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	19	80	100	$860	$719.1K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	12	40	100	$850	$680.6K
G0378	Hospital observation service, per hour	70	160	2,840	$80	$529.2K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	176	180	1,760	$140	$494.1K
42830	The provider performs an initial adenoidectomy in a patient who is less than 12 years old.	12	20	220	$940	$433.3K
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…	17	30	620	$130	$428.2K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	240	270	8,700	$10	$353.7K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	105	430	560	$60	$303.2K

Showing 1–10 of 152

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Health - St Vincent Medical Center LLC	OH	General Acute Care Hospital	$0	$132.8M
Mercy Emergency Care Services, Inc.	OH	Emergency Medicine Physician	$0	$30.6M
Nwo Integrated Laboratories Mercy LLC	OH	Clinical Medical Laboratory	$990.8K	$13.5M
Mohammed Alo	OH	Cardiovascular Disease Physician	$256.6K	$27.2K
Sinan Alo	OH	Cardiovascular Disease Physician	$224.1K	$0
Syed Ali	OH	Cardiovascular Disease Physician	$169.5K	$310
Hassana Barazi	OH	Diagnostic Radiology Physician	$167.7K	$0
Joel Kammeyer	OH	Infectious Disease Physician	$156.4K	$2K
Mohammed Taleb	OH	Cardiovascular Disease Physician	$157.5K	$0
Khaled Abuhanttash	OH	Hospitalist Physician	$142.2K	$0

Nationwide Children's Hospital Toledo, LLC — Billing Profile & Reimbursement Data

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Nationwide Children's Hospital Toledo, LLC — 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