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.

Children's Hospital Medical Center Of Akron (NPI 1841328853)

Key Findings

Field	Value
Entity Type	Organization
Organization	Children's Hospital Medical Center Of Akron
Address	1 Perkins Sq
City	Akron
State	OH
ZIP	44308
Taxonomy	Pediatrics Physician
NPI Enumerated	March 1, 2007

Payer Source	Total Paid
Medicaid	$87.2M
Medicare	$0

CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON is effectively a Medicaid-focused provider: it has no Medicare billing on file and reports $87.2M in lifetime Medicaid revenue. The absence of Medicare receipts combined with substantial Medicaid volume indicates that the provider's patient mix and reimbursement exposure are concentrated in the Medicaid program.

Revenue is heavily concentrated in a small set of outpatient E/M codes: the precomputed top three Medicaid codes account for 54.9% of the provider's total Medicaid revenue. Those top contributors are 99213 ($24.4M, 30.8%), 99214 ($11M, 13.8%), and 99283 ($8.2M, 10.3%), showing reliance on high-volume office visits and lower-acuity ED E/M encounters.

The code mix points to a large, integrated pediatric ambulatory and preventive care operation: very high volumes for well-care codes (99392, 99391, 99393, 99394) alongside 99213/99214 office visits and 90460 vaccine administration indicate routine well-child visits, immunizations, and chronic care management are core services. Preventive medicine codes 99392 ($6M, 7.6%) and 99391 ($4.8M, 6.0%) are sizable contributors, reinforcing a strong primary-care and immunization workflow.

Emergency and urgent pediatric care is a major service line: 99283 ($8.2M) ranks #2 of 484 providers in-state (100th percentile; extreme outlier) and 99284 ($5.6M) ranks in the 96th percentile, while 99285 ($1.5M) sits at a typical state volume. These rank and percentile signals show the provider operates a high-volume pediatric ED or urgent-care function relative to in-state peers.

The hospital also delivers a range of procedure-driven pediatric services beyond routine visits: notable revenues and ranks include EEG interpretation 95720 ($759.3K, 1.0%), surgical pathology 88305 ($726.5K, 0.9%), tympanostomy 69436 ($586.1K, 0.7%), and allergy testing 95004 ($512.3K, 0.6%). This mix demonstrates capacity for inpatient/operating-room procedures, diagnostic testing, and specialty outpatient procedures in addition to primary care.

On competitive standing within Ohio, this provider is a dominant statewide participant for many pediatric outpatient and preventive codes: 99213 ranks #3 of 5077 providers (100th percentile; extreme outlier), 99214 ranks #13 of 4514 (100th percentile; extreme outlier), and multiple other codes fall at or near the 100th percentile. Those rank/percentile descriptors indicate the provider is far above typical state volume for core pediatric codes and functions as a major regional provider for children’s services.

Because the organization reports no Medicare revenue and $87.2M in Medicaid receipts, its payer mix is effectively single-payer (Medicaid) in scale; strategic, operational, and revenue risks are therefore concentrated on Medicaid reimbursement patterns and policy changes. This concentration suggests Medicaid payment policy and managed-Medicaid contracts will drive revenue sensitivity more than Medicare dynamics.

The provider has been NPI-enumerated since 2007-03-01 (~19 years ago), signaling long-standing operational tenure. Combined with the high volumes and strong state rankings across multiple pediatric codes, the tenure supports characterization as an established, high-capacity pediatric center in the Akron region.

Medicaid: Complete Services Breakdown

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

208 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…	940,010	$30	$24.4M
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…	268,090	$40	$11M
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.	241,620	$30	$8.2M
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…	177,060	$30	$6M
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.	96,860	$60	$5.6M
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…	158,620	$30	$4.8M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	76,350	$30	$2.6M
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…	32,680	$60	$1.9M
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	28,630	$60	$1.6M
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…	28,830	$60	$1.6M

Showing 1–10 of 208

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

Children's Hospital Medical Center Of Akron — 19 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

208 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	2	480	4,510	$90	$1.8M
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.	24	660	460	$90	$1.5M
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.	7	10	1,020	$280	$1.3M
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.	105	580	510	$100	$1.3M
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.	10	10	480	$290	$1.2M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	6	20	4,730	$90	$818.4K
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	7	20	1,320	$90	$727.9K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	6	80	100	$860	$719.1K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	8	40	100	$850	$680.6K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	225	290	1,380	$90	$635.2K

Showing 1–10 of 208

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Hospital Medical Center Of Akron	OH	Children's Hospital	$0	$556.2M
Mercy Clinic Springfield Communities	MO	Family Medicine Physician	$0	$15.1M
David Miller	OH	Retina Specialist (Ophthalmology) Physician	$4.8M	$0
Christina Cernik	OH	Dermatology Physician	$142.6K	$0
Harry Kellermier	OH	Anatomic Pathology & Clinical Pathology Physician	$59.8K	$1.5K
Mary Lynne Garrett	OH	Nurse Practitioner	$39.3K	$0
Michelle James	OH	Physician Assistant	$9.9K	$0
Clayton Smith	OH	Adult Congenital Heart Disease Physician	$4.8K	$0
Amanda Lingenfelter	OH	Certified Registered Nurse Anesthetist	$2.6K	$1.3K
Adam Patterson	OH	Certified Registered Nurse Anesthetist	$1.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Portage Path Community Mental Health Center	OH	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$19.9M
City Of Akron Oh	OH	Ambulance	$485.6K	$4.2M
Erin Murphy	OH	Radiation Oncology Physician	$48.4K	$0
Alex Singleton	OH	Vascular & Interventional Radiology Physician	$25.7K	$0
Sylvia Obradovich	OH	Clinical Psychologist	$17.4K	$0
Kathleen Scroggins	OH	Family Medicine Physician	$10.2K	$0

Children's Hospital Medical Center Of Akron — Billing Profile & Reimbursement Data

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Children's Hospital Medical Center Of Akron — 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