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

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

Childrens Hospital Medical Practice Corporation (NPI 1821090713)

Key Findings

Field	Value
Entity Type	Organization
Organization	Childrens Hospital Medical Practice Corporation
Address	298 Henry Clay Ave
City	New Orleans
State	LA
ZIP	70118
Taxonomy	Pediatrics Physician
NPI Enumerated	August 11, 2005

Payer Source	Total Paid
Medicaid	$33.2M
Medicare	$0

This provider is effectively single‑payer in the available data: Medicare billing shows none on file while Medicaid revenue totals $33.2M, indicating the practice’s revenue base is dominated by Medicaid. The absence of Medicare activity is consistent with the Pediatrics Physician taxonomy and a child-focused patient panel.

Revenue concentration is high: the top three Medicaid codes (99213, 99214, 99392) account for 61.0% of the provider’s total Medicaid revenue. Those three codes individually generate $9.3M (29.6%) from 99213, $6.6M (21.0%) from 99214, and $3.3M (10.4%) from 99392, signaling that routine outpatient visits and preventive care are the primary revenue drivers.

The service mix is centered on outpatient pediatric care and preventive visits: high volumes in 99213 and 99214 reflect heavy established-patient E/M activity, while 99392 (preventive medicine) and related well‑child codes (99391, 99393, 99394) show a substantial emphasis on scheduled wellness visits and immunizations (90471, 90472). This pattern suggests clinic-based primary pediatric care with integrated preventive services and immunization delivery.

Competitive standing across key outpatient codes is dominant within the state. The provider ranks as an extreme outlier for 99213 (217K claims; ranks #11 of 3226, 100th percentile, extreme outlier) and 99214 (107K claims; ranks #17 of 2894, 99th percentile, extreme outlier), and is also an extreme outlier on 99392 (51.3K claims; ranks #3 of 415, 100th percentile, extreme outlier), indicating market leadership in routine pediatric ambulatory care.

The broader preventive visit footprint spans multiple pediatric age bands and reinforces the primary-care orientation: 99391 (54.5K claims, $3.1M, 9.8% of Medicaid revenue; ranks #3 of 364, 99th percentile, extreme outlier), 99393 (29.8K claims, $1.9M, 6.1%; ranks #3 of 494, 100th percentile, extreme outlier) and 99394 (17.6K claims, $1.2M, 3.9%; ranks #4 of 492, 99th percentile, extreme outlier) together show consistent well‑child activity across infancy, childhood, and adolescence.

The provider also performs inpatient and higher‑acuity services alongside ambulatory care: notable Medicaid lines include 99232 (18.4K claims, $700.2K, 2.2%), 99233 (7.1K claims, $393K, 1.2%), 99238 (6.3K claims, $296.2K, 0.9%), and critical/neo‑natal follow‑up codes such as 99291 (1.8K claims, $260.8K, 0.8%) and 99472 (1.1K claims, $223.9K, 0.7%). These entries indicate the practice provides some inpatient follow‑up and critical/newborn care in addition to clinic visits.

Specialized diagnostic volumes are present but not dominant: echocardiography codes such as 93306 (2.1K claims, $164.2K; rank #57 of 193, 71st percentile, typical, unremarkable) and 93303 (2.4K claims, $144.7K; rank #13 of 26, 52nd percentile, typical, unremarkable) show the provider offers cardiology imaging services at modest, expected levels relative to in‑state peers. This suggests in‑house capability for pediatric cardiac evaluation but not leading statewide volume for these specialized diagnostics.

The NPI tenure (enumerated 2005-08-11, ~21 years ago) combined with sustained, very large Medicaid volumes implies an established pediatric operation with long-term Medicaid reliance. Given the predominance of Medicaid revenue and the pediatric code mix, the provider appears structured around high outpatient throughput for children and adolescents rather than Medicare-served older adult care.

Medicaid: Complete Services Breakdown

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

190 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	217,040	$40	$9.3M
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…	107,000	$60	$6.6M
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…	51,350	$60	$3.3M
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…	54,510	$60	$3.1M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	29,760	$70	$1.9M
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,…	52,070	$30	$1.4M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	17,620	$70	$1.2M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	18,430	$40	$700.2K
99204	The provider sees a new 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 provider…	7,200	$80	$582.9K
99203	The provider sees a new 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 provider…	9,110	$60	$510.3K

Showing 1–10 of 190

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Louisiana Distribution

Childrens Hospital Medical Practice Corporation — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Louisiana

Full comparison — all codes billed, vs. Louisiana median

190 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	239	270	9,980	$110	$2.6M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	17	20	1,890	$280	$1M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	4	10	630	$270	$927K
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	14	20	5,680	$100	$863.1K
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…	13	30	2,260	$110	$460.1K
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	15	20	600	$90	$381.2K
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…	17	2,890	980	$40	$246.8K
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…	134	210	630	$70	$239.6K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	57	190	660	$70	$234.9K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	34	150	340	$120	$204.6K

Showing 1–10 of 190

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Louisiana State University School Of Med In New Orleans Faculty Grou	LA	Pediatrics Physician	$0	$43M
Christopher Cheng	CA	Neurology Physician	$239.3K	$36.2K
Edward Barton	CA	Neurology Physician	$260.1K	$0
John Parker	CA	Neurology Physician	$243K	$0
David Valentine	CA	Neurology Physician	$233.3K	$0
Greg Schaublin	FL	Neurology Physician	$202.8K	$0
Ernesto Mejia	TN	Pulmonary Disease Physician	$173.7K	$0
Justin Cheongsiatmoy	CO	Neurology Physician	$96.9K	$0
Ken Fujimura	CA	Neurology Physician	$70.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Hospital	LA	Children's Hospital	$0	$150.9M
Children's Hospital	LA	Specialist	$0	$24.4M
Marillac Community Health Centers	LA	Federally Qualified Health Center (FQHC)	$0	$24.2M
Children's Hospital	LA	Specialist	$0	$9.8M
Acadia Health, LLC	LA	General Practice Dentistry	$0	$9.6M
Jamie Yeager	LA	Student in an Organized Health Care Education/Training Program	$302.6K	$0
Cary Donohue	LA	Podiatrist	$119.3K	$122.4K
Leslee Mcnabb	LA	Diagnostic Radiology Physician	$195.6K	$0
Nathan Macaluso	LA	Physical Therapist	$114.1K	$0
Felix Savoie	LA	Sports Medicine (Orthopaedic Surgery) Physician	$95.1K	$0

Childrens Hospital Medical Practice Corporation — 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