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    v1.0.28
    OpenPayerNPI Medicare & MedicaidDaniel Childs
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    Daniel Childs — Billing Profile & Reimbursement Data

    NPI 1851770036 · Rochester, MN · Medical Oncology Physician

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    Daniel Childs is a medical oncology physician provider located in Rochester, Minnesota. This profile covers 46 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationDaniel Childs
    Address200 1st St Sw
    CityRochester
    StateMN
    ZIP55905
    TaxonomyMedical Oncology Physician
    NPI EnumeratedMay 21, 2015

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$1.1M
    Medicaid$0

    Key Findings

    This provider’s commercial footprint is effectively single‑payer: lifetime Medicare revenue is $1.1M while there is no Medicaid billing on file. The absence of any Medicaid claims indicates the practice derives its reported public-payer volume and cashflows entirely from Medicare patients.

    Revenue is highly concentrated in a handful of infused oncology agents: the precomputed top‑3 codes account for 84.1% of the provider’s total Medicare revenue. Those three codes are J9271 ($488.1K, 44.8%), J9144 ($273.9K, 25.1%), and J9299 ($154.6K, 14.2%), showing the practice’s financial exposure is heavily weighted to a few high-cost biologic/immunotherapy drugs.

    The code mix and descriptions point to an infusion-centered medical oncology practice: the top revenue drivers are high-cost injections (J9271 – pembrolizumab, J9144 – daratumumab, J9299 – nivolumab) rather than evaluation-and-management services. E/M codes are present but small — for example, 99214 generated $11.8K (1.1%) and 99205 generated $9.1K (0.8%) — suggesting clinical workflow and revenue depend primarily on drug administration.

    Operational intensity is evident in claims volume for key biologics: J9271 has 12.2K claims with an average paid of $40 and J9144 has 7.2K claims with an average paid of $38, indicating frequent administrations of these agents even though each claim’s average payment is moderate. By contrast, chemotherapy administration CPTs such as 96413 (233 claims, $24.5K, 2.2%) contribute materially less to revenue than the top biologic injectables, reinforcing a drug-revenue–dominant business model.

    On competitive standing for Medicare-covered drugs, this provider is a modest, nationally typical participant rather than a dominant player. J9271 ranks #929 of 1841 (50th percentile; described as typical, unremarkable volume), J9144 ranks #351 of 615 (43th percentile; described as typical, unremarkable volume), and J9299 ranks #448 of 505 (11th percentile; described as typical, unremarkable volume) — these ranks imply the provider’s volumes are in line with many peers but not at market-leading levels.

    Several secondary drug and supportive-care codes appear at low national placement but are still labeled in the source as typical in volume; for example, Q5119 contributed $21.2K (1.9%) and ranks #324 of 335 (3th percentile; described as typical, unremarkable volume), while J2506 contributed $12.6K (1.2%) and ranks #568 of 586 (1th percentile; described as typical, unremarkable volume). These line items indicate the practice uses a range of biologic and supportive agents but does not show broad national leadership for those specific products.

    The practice’s revenue profile suggests limited diversification beyond infused oncology drugs: many add‑on and administration codes appear with modest revenue (e.g., 96417 $4.5K, 0.4%; 96401 $6.3K, 0.6%), implying that supply‑and‑administration services and longer infusion-hour billings are present but secondary. That pattern can inform payer strategies around site-of-care management and drug utilization reviews, since drug costs dominate the Medicare payments reported.

    The provider has an established billing history, with the NPI enumerated on 2015-05-21 (~11 years ago), which supports interpretation of the observed pattern as a sustained operating model rather than a transient billing profile. Given the long tenure and concentrated drug-revenue mix, analyses of trend over time and comparisons to local infusion centers would help assess whether the provider’s code mix is stable or shifting among immunotherapy and monoclonal antibody agents.

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    46 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J9271Injection, pembrolizumab, 1 mg12,200$40$488.1K
    J9144Injection, daratumumab, 10 mg and hyaluronidase‑fihj7,210$40$273.9K
    J9299Injection, nivolumab, 1 mg6,440$20$154.6K
    J9264Injection, paclitaxel protein-bound particles, 1 mg2,730$10$27.3K
    96413Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…230$110$24.5K
    Q5119Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg920$20$21.2K
    Q5116Injection, trastuzumab-qyyp, biosimilar, (trazimera), 10 mg580$20$13.9K
    J2506Injection, pegfilgrastim, excludes biosimilar, 0.5 mg160$80$12.6K
    99214The 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…120$100$11.8K
    99205The provider sees a new 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 provider…60$160$9.1K

    Showing 1–10 of 46

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 46 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    46 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J927110707,200$40$323.3K
    J91444503,780$40$163.7K
    J92997205,240$20$159.4K
    J25061520290$80$34.3K
    Q511926301,380$20$29.5K
    J92645102,760$10$27.1K
    J9217738080$130$17.1K
    Q5116110510$20$11.6K
    964133723070$100$11.5K
    992142,79210,10070$80$8.1K

    Showing 1–10 of 46

    Nearby Providers

    Other providers in the same ZIP code as Daniel Childs, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Mayo ClinicMNMulti-Specialty Clinic/Center$0$74.3M
    Mayo Collaborative Services, IncMNClinical Medical Laboratory$6.5M$39.2M
    Mayo ClinicMNClinical Medical Laboratory$12.2M$15.2M
    Mayo ClinicMNMulti-Specialty Clinic/Center$0$10.9M
    Mayo Foundation For Medical Education & ResearchMNDurable Medical Equipment & Medical Supplies$9.3K$2.8M
    Vidhu KaushikMNClinical Pathology/Laboratory Medicine Physician$59.6K$1.9M
    Roberto Leon FerreMNMedical Oncology Physician$1.3M$0
    Peter NoseworthyMNCardiovascular Disease Physician$1.1M$0
    Robert JacobsonMNPediatrics Physician$975.6K$0
    Brittany SiontisMNMedical Oncology Physician$960.6K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Minnesota Distribution
    Daniel Childs — 1 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Minnesota