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

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

Shield California Health Care Center Inc (NPI 1881708899)

Field	Value
Entity Type	Organization
Organization	Shield California Health Care Center Inc
Address	27911 Franklin Pkwy
City	Valencia
State	CA
ZIP	91355
Taxonomy	Parenteral & Enteral Nutrition Supplies (DME)
NPI Enumerated	August 18, 2006

Payer Source	Total Paid
Medicaid	$523.3M
Medicare	$0

Key Findings

SHIELD CALIFORNIA HEALTH CARE CENTER INC is effectively a Medicaid-focused DME supplier: the entity reports $523.3M in Medicaid revenue and has no Medicare billing on file. Its NPI was enumerated on 2006-08-18 (~20 years ago), indicating a long tenure in the Medicaid supplier market rather than a recent entrant.

Revenue is highly concentrated in a small set of incontinence-related codes: the precomputed top three Medicaid codes account for 39.5% of total Medicaid revenue, with T4541 alone representing 20.3% of the provider's Medicaid receipts. This concentration indicates that disposable incontinence underpads and related products are the primary revenue drivers for the business.

The provider is a statewide dominant supplier for multiple incontinence product lines. For example, T4541 ranks #1 of 288 providers in-state (100th percentile; extreme outlier), T4535 ranks #1 of 230 providers in-state (100th percentile; extreme outlier), and T4527 ranks #1 of 195 providers in-state (100th percentile; extreme outlier), signaling market-leading volumes far above typical state peers for these codes.

Beyond incontinence supplies, the billing mix shows substantial enteral nutrition and accessory activity consistent with a combined incontinence/enteral DME operator: B4035 (enteral feeding supply kit) generated $21.1M and ranks #1 of 76 providers in-state (100th percentile; extreme outlier), B4160 and B4161 (pediatric enteral formulas) and B9002 (enteral pumps) also appear on the top list, demonstrating a meaningful enteral supplies line alongside incontinence products.

The provider’s product mix balances very high-volume, low-unit-price items with lower-volume, high-unit-price supplies. Examples include very large claim counts for A6250 (833.9K claims, $12 avg paid/claim) and A4335 (865.9K claims, $11 avg paid/claim) versus higher-paid items such as A4351 (81.2K claims, $228 avg paid/claim) and B9002 (7.4K claims, $514 avg paid/claim), implying operational scale in distribution plus some specialized, higher-margin device provision.

Competitive standing is heterogeneous across its portfolio: the provider ranks as an extreme outlier at the state level (100th percentile) on many incontinence and enteral codes, establishing it as a dominant in-state supplier for those lines, while certain specialized items are less exceptional—for instance A4351 ranks #2 of 39 providers in-state (97th percentile) and B9002 ranks #5 of 45 providers in-state (91th percentile; typical, unremarkable volume for this code).

The breadth of reimbursed codes shows the business spans incontinence products (T45xx series), enteral supplies and formula (B4xxx and B9xxx codes), urinary catheters (A4351), and ostomy supplies (A4385, A4409), indicating an integrated DME supply operation serving a range of chronic care needs. This diversity suggests multiple clinical use-cases (incontinence management, enteral nutrition, catheter care, ostomy care) contributing to the Medicaid revenue base.

Given the lack of Medicare billing and the heavy Medicaid concentration, payer mix risk is concentrated: the organization’s financial performance and market position are exposed predominantly to Medicaid policy, reimbursement, and procurement practices rather than to Medicare trends. Analysts should treat this entity as effectively single-payer (Medicaid) for strategic or contracting considerations.

Medicaid: Complete Services Breakdown

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

152 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T4541	Incontinence product, disposable underpad, large, each	1,800,430	$50	$93.6M
T4535	Disposable liner/shield/guard/pad/undergarment, for incontinence, each	1,278,710	$40	$49.9M
T4527	Adult sized disposable incontinence product, protective underwear/pull-on, large size, each	603,240	$60	$38.6M
T4526	Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each	681,010	$50	$36.1M
T4523	Adult sized disposable incontinence product, brief/diaper, large, each	283,230	$80	$23.5M
T4528	Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each	361,110	$70	$23.5M
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	155,360	$140	$21.1M
T4534	Youth sized disposable incontinence product, protective underwear/pull-on, each	148,400	$130	$19M
A4351	Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each	81,170	$230	$18.5M
T4522	Adult sized disposable incontinence product, brief/diaper, medium, each	264,210	$70	$18.5M

Showing 1–10 of 152

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. California Distribution

Shield California Health Care Center Inc — 24 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. California median

152 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A4351	Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each	2	40	1,180	$290	$2.3M
A4239	Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service	12	30	420	$140	$2.2M
A4352	Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each	2	10	1,210	$390	$1.1M
T4541	Incontinence product, disposable underpad, large, each	1	290	2,820	$50	$1.1M
T4534	Youth sized disposable incontinence product, protective underwear/pull-on, each	1	40	1,220	$120	$1M
T4535	Disposable liner/shield/guard/pad/undergarment, for incontinence, each	1	230	2,740	$40	$860.2K
A4353	Intermittent urinary catheter, with insertion supplies	3	20	940	$470	$852.6K
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	1	80	1,720	$90	$686.6K
A6197	Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing	3	20	180	$140	$630.4K
T4530	Pediatric sized disposable incontinence product, brief/diaper, large size, each	1	40	750	$80	$628.5K

Showing 1–10 of 152

Nearby Providers

Other providers in the same ZIP code as Shield California Health Care Center Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Los Angeles County Department Of Mental Health	CA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$38.9M
Advanced Bionics, LLC.	CA	Durable Medical Equipment & Medical Supplies	$6.9M	$25.3M
Alexander Black	CA	Hematology & Oncology Physician	$1.4M	$0
Joshua Hanelin	CA	Diagnostic Radiology Physician	$1.2M	$0
Tourney Plaza Surgical Center	CA	Ambulatory Surgical Clinic/Center	$973.3K	$0
Craig Helm	CA	Ophthalmology Physician	$586.2K	$0
Franco Garcia	CA	Physician Assistant	$475.2K	$0
Jared Niska	CA	Orthopaedic Hand Surgery Physician	$371.1K	$0
Samad Zaheeruddin	CA	Interventional Cardiology Physician	$365.8K	$0
Rena Callahan	CA	Internal Medicine Physician	$362.5K	$0

Shield California Health Care Center Inc — Billing Profile & Reimbursement Data

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Shield California Health Care Center Inc — 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

Nearby Providers

Frequently Asked Questions

References