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.

Nationwide Children's Hospital (NPI 1851179873)

Nationwide Children's Hospital is a multi-specialty clinic/center provider located in Columbus, Ohio. This profile covers 0 Medicare and 70 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	Nationwide Children's Hospital
Address	700 Childrens Dr
City	Columbus
State	OH
ZIP	43205
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	September 20, 2023

Payer Source	Total Paid
Medicaid	$13M
Medicare	$0

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

70 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…	168,120	$30	$5.4M
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…	58,000	$50	$2.7M
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…	24,690	$30	$839.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	19,020	$40	$684.6K
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…	23,100	$30	$669.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	10,940	$40	$459.5K
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…	6,320	$60	$378.9K
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…	7,230	$40	$260.3K
99188	The provider applies a fluoride adhesive over the tooth surface to prevent tooth decay, provide remineralization, or treat hypersensitivity.	11,010	$20	$242.1K
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…	3,670	$60	$205.5K

Showing 1–10 of 70

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

Nationwide Children's Hospital — 10 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

70 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
36512	Apheresis (also known as pheresis or therapeutic pheresis) is a medical procedure utilizing specialized equipment to remove selected blood constituents (plasma, leukocytes, platelets, or cells) from…	6	10	320	$1,210	$705.2K
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…	83	4,510	500	$60	$377.8K
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…	28	5,080	560	$40	$323.9K
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…	13	430	560	$60	$303.2K
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…	12	480	450	$70	$292.9K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	241	270	420	$90	$276K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	372	810	2,560	$50	$274.4K
64643	The provider injects a chemical, such as Botox®, into one to four muscles of an additional extremity after the first to relieve a patient's pain and spasms.	7	20	310	$340	$258K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	71	90	770	$100	$250.1K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	382	840	1,040	$50	$220.1K

Showing 1–10 of 70

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nationwide Children's Hospital	OH	General Acute Care Hospital	$0	$777.8M
Ohiohealth Corporation	OH	Family Medicine Physician	$0	$89.1M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Nationwide Children's Hospital	OH	Home Infusion Agency	$0	$22.4M
Nationwide Children's Hospital Homecare	OH	Home Health Agency	$0	$17.5M
Nationwide Children's Hospital	OH	Dental Clinic/Center	$0	$11.1M
Nationwide Children's Hospital	OH	Home Health Agency	$0	$6.7M
Cameron Nabavi	OH	Ophthalmology Physician	$264.2K	$0
Kenneth Cahill	OH	Ophthalmology Physician	$198.4K	$0
Miguel Lugo	FL	Ophthalmology Physician	$188.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pediatric Academic Association, Inc.	OH	Pediatrics Physician	$0	$37.2M
St Vincent Family Centers	OH	Adolescent and Children Mental Health Clinic/Center	$0	$29.6M
River's Crossing Home Care LLC	OH	Home Health Agency	$0	$15.2M
Pediatric Ophthalmology Associates Inc.	OH	Ophthalmology Physician	$0	$9.5M
Columbus Neighborhood Health Center Inc	OH	Federally Qualified Health Center (FQHC)	$0	$8.7M
Manmohan Katapadi	OH	Cardiovascular Disease Physician	$183.2K	$25.3K
Thomas Keeling	OH	Infectious Disease Physician	$204.5K	$0
James Smith	OH	Infectious Disease Physician	$190.3K	$0
Matthew Robertson	OH	Diagnostic Radiology Physician	$108.7K	$0
Rodney Kusumi	OH	Infectious Disease Physician	$96.8K	$0

Nationwide 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

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