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

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

Valley Children's Hospital (NPI 1700949336)

Field	Value
Entity Type	Organization
Organization	Valley Children's Hospital
Address	9300 Valley Childrens Pl
City	Madera
State	CA
ZIP	93636
Taxonomy	Children's Hospital
NPI Enumerated	December 18, 2006

Payer Source	Total Paid
Medicaid	$107M
Medicare	$0

Medicaid: Complete Services Breakdown

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

514 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
0360	N/A	18,410	$630	$11.6M
0450	N/A	285,150	$40	$10.3M
Z7500	N/A	153,750	$30	$5.2M
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	80,190	$60	$4.7M
0710	N/A	17,230	$220	$3.8M
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…	24,970	$150	$3.7M
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	2,970	$1,050	$3.1M
99281	The provider sees a patient for the lowest level emergency department visit.	30,820	$80	$2.6M
70551	The provider uses magnetic resonance imaging, or MRI, to examine the brain and brain stem. The provider does not administer contrast for this exam.	4,200	$550	$2.3M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	31,370	$60	$1.8M

Showing 1–10 of 514

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. California Distribution

Valley Children's Hospital — 13 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. California median

514 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
0450	N/A	4	450	16,140	$90	$3.6M
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.	588	1,570	680	$110	$1.1M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	16	40	200	$1,990	$1M
L8699	Prosthetic implant, not otherwise specified	11	50	220	$1,790	$996.4K
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.	377	1,300	510	$100	$943K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	42	750	950	$50	$890K
V5298	Hearing aid, not otherwise classified	18	130	180	$1,180	$870.5K
0510	N/A	34	230	930	$40	$854K
99281	The provider sees a patient for the lowest level emergency department visit.	28	430	1,140	$90	$769.9K
G0378	Hospital observation service, per hour	66	200	550	$310	$605.9K

Showing 1–10 of 514

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Valley Children's Hospital	CA	Children's Hospital	$0	$22.8M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ji Kwon	CA	Nurse Practitioner	$3.7K	$0
Paolo Aquino	CA	Pediatric Cardiology Physician	$1.8K	$0

Valley Children's Hospital — Billing Profile & Reimbursement Data

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Valley Children's Hospital — 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