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

Why is the Medicaid comparison limited to Pennsylvania 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. Pennsylvania (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 Of Philadelphia (NPI 1629168232)

Children's Hospital Of Philadelphia is a pediatrics physician provider located in Philadelphia, Pennsylvania. This profile covers 0 Medicare and 57 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Children's Hospital Of Philadelphia
Address	1700 S Broad St. Ste 301
City	Philadelphia
State	PA
ZIP	19145
Taxonomy	Pediatrics Physician
NPI Enumerated	October 13, 2006

Payer Source	Total Paid
Medicaid	$5.5M
Medicare	$0

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

57 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…	15,330	$100	$1.5M
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…	22,600	$60	$1.3M
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	7,110	$70	$526K
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…	7,490	$50	$344.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	6,480	$40	$285.1K
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…	4,310	$50	$219.8K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	14,840	$10	$163.3K
99499	Use 99499 to report evaluation and management services for which there is no specific code available.	6,750	$20	$161.9K
92551	The provider delivers a limited series of tones or sounds to a patient to determine if the patient’s hearing is in an acceptable range to detect hearing problems.	12,470	$10	$149.6K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,070	$60	$128.4K

Showing 1–10 of 57

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

Children's Hospital Of Philadelphia — 22 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

57 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	19	820	230	$80	$71.7K
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…	81	8,160	210	$60	$68.4K
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…	28	660	180	$70	$63.7K
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…	84	8,870	240	$40	$56.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	15	870	160	$70	$48.2K
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…	1,076	1,210	100	$90	$45K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	34	730	90	$70	$31.5K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	7	380	140	$30	$27.1K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	21	120	70	$70	$18.4K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	46	540	130	$10	$15.3K

Showing 1–10 of 57

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Norah's Care Agency, LLC.	PA	Home Health Agency	$0	$15.5M
Crisis Management Services	PA	Substance Abuse Rehabilitation Facility	$0	$13.7M
City Of Philadelphia	PA	Federally Qualified Health Center (FQHC)	$0	$13.5M
Methodist Hospital	PA	General Acute Care Hospital	$0	$10.7M
American Access Care Of Sp Asc LLC	PA	Ambulatory Surgical Clinic/Center	$2.5M	$267.2K
Stadium Campus Ambulatory Surgical Center, LLC	PA	Ambulatory Surgical Clinic/Center	$793.2K	$1.4M
Briana Massetti	PA	Acute Care Nurse Practitioner	$565.7K	$55K
Eric Newman	PA	Nephrology Physician	$455.4K	$4.5K
Wayne Dunn	PA	Ophthalmology Physician	$425.6K	$0
Concetta Milano	PA	Cardiovascular Disease Physician	$419.9K	$0

Children's Hospital Of Philadelphia — Billing Profile & Reimbursement Data

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Children's Hospital Of Philadelphia — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Childrens Hospital Of Philadelphia	PA	Children's Hospital	$0	$286.9M
Children's Hospital Of Philadelphia	PA	Durable Medical Equipment & Medical Supplies	$0	$27.6M
Children's Hospital Of Philadelphia	PA	Home Infusion Agency	$0	$23.1M
The Children's Hospital Of Philadelphia	PA	Pediatrics Physician	$0	$11.9M
Children's Hospital Of Philadelphia	PA	Pediatrics Physician	$0	$5.7M
Saifuddin Mama	NJ	Obstetrics & Gynecology Physician	$24.1K	$0
Meghna Patel	PA	Neuromusculoskeletal Medicine & OMM Physician	$13.1K	$0