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

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

Pediatric Home Respiratory Services LLC (NPI 1629141213)

Field	Value
Entity Type	Organization
Organization	Pediatric Home Respiratory Services LLC
Address	2800 Cleveland Ave N
City	Roseville
State	MN
ZIP	55113
Taxonomy	Durable Medical Equipment & Medical Supplies
NPI Enumerated	November 15, 2006

Payer Source	Total Paid
Medicaid	$197.4M
Medicare	$0

Key Findings

PEDIATRIC HOME RESPIRATORY SERVICES LLC is effectively a Medicaid-centric DME supplier: lifetime Medicaid revenue is $197.4M and the provider has no Medicare billing on file, making Medicaid the sole recorded payer in this dataset. The NPI was enumerated 2006-11-15 (~20 years ago), indicating long-tenured operation in its market.

Revenue is highly concentrated in a few code lines: the precomputed top 3 Medicaid codes (E0465, B4149, B4035) account for 43.6% of this provider's total Medicaid revenue. Those three codes individually include E0465 ($30.2M, 17.7% of total), B4149 ($24.6M, 14.4% of total), and B4035 ($19.5M, 11.5% of total), underscoring a reliance on ventilator and enteral nutrition products.

The mix of top codes points to a combined home respiratory and enteral nutrition business model focused on complex pediatric patients: E0465 and E0466 are home ventilator codes (invasive and non-invasive), while B4149, B4161, B4160, B4035 and multiple B41xx codes are enteral formulas and pump/supply items. High claim counts for supplies—e.g., B4035 66.1K claims, B4149 46.7K claims, and B9998 97.2K claims—suggest a recurring consumables and distribution operation rather than episodic device sales alone.

The provider is a statewide leader on many core Medicaid codes: it ranks #1 of 8 providers in-state for E0465 (100th percentile), #1 of 5 for B4149 (100th percentile), and #1 of 18 for B4035 (100th percentile). These #1 ranks across multiple high-revenue codes indicate dominant standing within Minnesota for both ventilator-related and enteral supply lines.

Several codes are flagged as statistical outliers in the state data: B4035 and B9998 are described as "extreme outlier, far above typical state volume," while E0465, B4149, B4035, B4161, B4160 and many other codes are characterized as "notably above typical state volume." These labels reinforce that the provider operates at volumes well beyond typical in-state peers for its core product lines.

There is some variation within the ventilator category: the invasive ventilator code E0465 is a clear statewide leader, while the non-invasive ventilator code E0466 ranks #3 of 13 providers (83th percentile) and is described as "typical, unremarkable volume." This divergence suggests the provider’s strength is concentrated in invasive ventilator services/equipment rather than non-invasive ventilator supply.

Operational footprint is weighted toward high-volume, lower-unit-cost consumables and recurring equipment services: examples include B9998 (97.2K claims at $105 avg paid/claim), B4035 (66.1K claims at $295 avg paid/claim), and A4606 (35K claims at $137 avg paid/claim). The combination of very large claim counts and substantial aggregated revenue implies significant logistics, inventory, and recurring fulfillment capabilities.

From a payer-mix and strategic perspective, the absence of Medicare billing on file means the provider lacks recorded diversification into Medicare revenue streams and is effectively single-payer (Medicaid) in this dataset. Analysts evaluating competitive position or contracting should weigh both the provider’s clear statewide dominance on multiple codes and the concentration risk of relying on Medicaid as the sole recorded payer.

Medicaid: Complete Services Breakdown

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

153 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
E0465	Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)	23,890	$1,260	$30.2M
B4149	Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral…	46,680	$530	$24.6M
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	66,090	$300	$19.5M
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…	30,420	$560	$16.9M
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,…	44,430	$250	$11M
B9998	Noc for enteral supplies	97,240	$110	$10.2M
B4153	Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral…	5,290	$1,450	$7.7M
B4088	Gastrostomy/jejunostomy tube, low-profile, any material, any type, each	48,790	$140	$6.6M
E0466	Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)	4,650	$1,350	$6.3M
A4606	Oxygen probe for use with oximeter device, replacement	34,980	$140	$4.8M

Showing 1–10 of 153

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Minnesota Distribution

Pediatric Home Respiratory Services LLC — 18 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. Minnesota median

153 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
E0482	Cough stimulating device, alternating positive and negative airway pressure	3	10	7,590	$380	$5.6M
B4149	Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral…	1	10	580	$510	$5M
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	10	890	$570	$4.6M
E0465	Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)	1	10	720	$1,090	$4.4M
S8120	Oxygen contents, gaseous, 1 unit equals 1 cubic foot	2	10	34,960	$90	$3.2M
B4153	Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral…	1	10	750	$1,190	$1.8M
E0466	Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)	3	10	1,020	$540	$1.5M
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,…	1	10	990	$230	$1.4M
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	1	20	960	$250	$1.3M
T4530	Pediatric sized disposable incontinence product, brief/diaper, large size, each	2	10	2,070	$140	$1.2M

Showing 1–10 of 153

Related Providers

Other providers that share a Tax Identification Number (TIN) with Pediatric Home Respiratory Services LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vgm Group, Inc.	IA	Durable Medical Equipment & Medical Supplies	$0	$54.4M
Pediatric Home Respiratory Services LLC	MN	Home Infusion Therapy Pharmacy	$0	$14.2M

Nearby Providers

Other providers in the same ZIP code as Pediatric Home Respiratory Services LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Acr Homes, Inc.	MN	Adult Care Home Facility	$0	$156M
Ablenet Inc	MN	Durable Medical Equipment & Medical Supplies	$0	$114.5M
Presbyterian Homes And Services	MN	Home Health Agency	$0	$37.9M
Midwest Radiology, PA	MN	Diagnostic Radiology Physician	$0	$31.2M
Brain Injury Association Of Minnesota	MN	Case Management Agency	$0	$26.9M
Sasaki Medical LLC	MN	Addiction Medicine (Family Medicine) Physician	$0	$24M
Minnesota Epilepsy Group PA	MN	Neurology Physician	$0	$9.2M
Roseville Ops LLC	MN	Assisted Living Facility	$0	$6.6M
Presbyterian Homes Hospice Inc	MN	Exclusive Provider Organization	$0	$5.5M
Option Care Enterprises, Inc.	MN	Home Infusion Therapy Pharmacy	$0	$5.4M

Pediatric Home Respiratory Services LLC — Billing Profile & Reimbursement Data

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Pediatric Home Respiratory Services LLC — 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