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 1861506560)

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	Children's Hospital
NPI Enumerated	August 18, 2006

Payer Source	Total Paid
Medicaid	$556.2M
Medicare	$0

CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON is effectively a single-payer Medicaid provider in the available data: there is no Medicare billing on file and total Medicaid revenue is $556.2M. This concentration means payer-facing strategies, utilization patterns, and competitive positioning should be evaluated primarily against Ohio Medicaid metrics rather than Medicare benchmarks.

Revenue concentration is heavily weighted toward ambulatory evaluation-and-management and preventive visits: the top three Medicaid codes (99213, 99214, 99392) together account for 52.6% of the provider's Medicaid revenue. Specifically, 99213 generated $146.7M (33.0% of total Medicaid revenue), 99214 generated $56.6M (12.7%), and 99392 generated $30.2M (6.8%), signaling that a small set of outpatient visit codes drive the bulk of revenue.

The code mix indicates a core pediatric ambulatory and preventive care operation: very high volumes for office/outpatient E/M (99213: 991.2K claims; 99214: 349.3K claims) and well-child visits (99392: 217K claims; 99391: 215.6K claims) point to large primary care and routine immunization throughput. Each of these codes ranks at or near the top statewide (e.g., 99213 ranks #2 of 5077 providers in-state at the 100th percentile and is described as an extreme outlier), supporting the interpretation of a high-volume pediatric ambulatory practice footprint.

Emergency and urgent pediatric services are also a material component of activity: ED E/M codes 99284 ($27.5M, 162K claims) and 99283 ($24.3M, 160.9K claims) contribute meaningfully and are reported as extreme outliers in state volume, while higher-acuity 99285 is more typical in-state. This pattern suggests the provider operates a high-volume pediatric emergency department handling a range of acuity levels, with particularly elevated volumes at moderate and low E/M levels.

The provider performs substantial procedural and surgical pediatric work in the operating room and specialty clinics: tympanostomy with ventilation tube 69436 produced $10.6M (5.7K claims) and tonsil/adenoid removal 42820 produced $5.2M (3.4K claims), both ranking above typical state volume (69436 at the 95th percentile, 42820 at the 95th percentile). These data indicate a significant ENT surgical service line supporting the outpatient and inpatient pediatric populations.

A broad set of ancillary therapies and diagnostics are prominent contributors to revenue and reflect a full-service pediatric center. High-volume audiology/hearing services (92551: $12.9M, rank #2 in-state), respiratory interventions (94640: $4.8M, rank #1 in-state), and rehabilitation codes (97530, 97110) are all reported as extreme outliers or notably above typical state volumes, implying integrated ancillary services such as audiology, respiratory therapy, and physical/occupational therapy that support complex pediatric care.

Testing and infectious disease diagnostics are notable lines of business: COVID-19 PCR testing U0003 generated $5.3M (21.6K claims) and multiplex respiratory testing 87633 generated $3.9M (22.1K claims) with 87633 ranked #1 of 58 providers in-state as an extreme outlier. These figures point to significant lab/testing throughput in addition to routine outpatient care, which may reflect on-site laboratory capacity or centralized testing workflows for pediatric populations.

The provider has an established presence in the market, with NPI enumerated on 2006-08-18 (~20 years ago), and demonstrates statewide dominance on multiple pediatric outpatient and ancillary codes. Repeated 100th-percentile placements and top-3 in-state ranks across core E/M, preventive, audiology, and respiratory codes indicate CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON is a leading Medicaid pediatric provider in Ohio rather than a modest or typical participant.

Medicaid: Complete Services Breakdown

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

717 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…	991,230	$150	$146.7M
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…	349,260	$160	$56.6M
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…	217,030	$140	$30.2M
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…	215,590	$130	$28.9M
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.	162,050	$170	$27.5M
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.	160,880	$150	$24.3M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	121,190	$140	$16.6M
92551	The provider delivers a limited series of tones or sounds to a patient to determine if the patient’s hearing is in an acceptable range to detect hearing problems.	142,130	$90	$12.9M
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	5,730	$1,860	$10.6M
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…	61,520	$160	$10.1M

Showing 1–10 of 717

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 — 17 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

717 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	136	150	4,030	$100	$5.9M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	51	170	4,660	$300	$2.6M
A0431	Ambulance service, conventional air services, transport, one way (rotary wing)	13	20	530	$2,040	$2.6M
81479	Use 81479 to report a molecular pathology procedure that does not have a specific code.	5	10	760	$50	$2M
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.	7	480	4,510	$90	$1.8M
J1569	Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg	7	10	890	$1,920	$1.7M
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.	14	660	460	$90	$1.5M
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.	40	580	510	$100	$1.3M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	6	20	260	$1,470	$1.1M
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…	14	140	1,130	$90	$1.1M

Showing 1–10 of 717

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Hospital Medical Center Of Akron	OH	Pediatrics Physician	$0	$87.2M
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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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