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

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

Childrens Health Care (NPI 1881793750)

Field	Value
Entity Type	Organization
Organization	Childrens Health Care
Address	2525 Chicago Ave S
City	Minneapolis
State	MN
ZIP	55404
Taxonomy	Children's Hospital
NPI Enumerated	September 21, 2006

Payer Source	Total Paid
Medicaid	$100M
Medicare	$0

Key Findings

This provider effectively operates as a Medicaid-focused pediatric system: there is no Medicare billing on file and total Medicaid revenue is $100M, so the organization is functionally single‑payer in the available dataset. The absence of Medicare activity implies Medicaid dominates both clinical throughput and reimbursement for this entity.

Revenue is heavily concentrated in a very small set of codes: the precomputed top three Medicaid codes (99283, 99284, and G0463) account for 69.9% of the provider's Medicaid revenue. Individually those codes are reported as $33.2M (34.7%), $18.2M (19.0%), and $15.5M (16.2%) respectively, indicating a reliance on emergency department and hospital outpatient clinic services for the majority of Medicaid dollars.

The code mix points to a high-volume pediatric emergency care operation. 99283 appears as an $33.2M revenue driver with 188.6K claims and ranks #3 of 218 in-state (99th percentile; extreme outlier), signaling emergency department visits at a level far above most peers. 99284 also contributes substantially ($18.2M, 66.3K claims) and together these ED E/M codes suggest that urgent/emergent encounters are a core service line.

Hospital outpatient clinic activity is another major business line: G0463 generated $15.5M on 161.1K claims and ranks #8 of 81 in-state (91th percentile; typical, unremarkable volume). This combination of high ED coding and large G0463 volume is consistent with a hospital-based pediatric system that manages both emergent and ambulatory follow-up care within an outpatient hospital setting.

The provider is a state leader for several high-volume diagnostic and lab-related codes, including two codes with no description available that nonetheless register as statewide extremes: 0241U (49.7K claims, $6.7M, rank #1 of 112; 100th percentile; extreme outlier) and 0240U (13.1K claims, $1.8M, rank #1 of 29; 100th percentile; extreme outlier). C9803 (COVID specimen collection) is also prominent at $1.1M on 52.9K claims and ranks #1 of 67 (100th percentile; extreme outlier), indicating exceptional throughput for testing/specimen collection compared with in‑state peers.

Preventive and routine pediatric services are another meaningful component of volume: 99392, 99393, 99391 and 99394 together appear in the top codes with claim counts in the tens of thousands (e.g., 99392: 20.8K claims, $1.5M; 99393: 20.6K claims, $1.4M), and vaccination administration 90471 is very high‑volume at 44.6K claims ($891.4K) and ranks #4 of 534 in-state (99th percentile; extreme outlier). These figures point to strong well‑child visit throughput and immunization delivery as a complementary outpatient service line.

Several individual codes show unusually high paid amounts per claim for the types of services billed, for example D7140 at $1121 avg paid/claim ($3M revenue) and 69436 at $902 avg paid/claim ($905.6K revenue). Combined with the high volumes for ED, outpatient clinic, and procedural codes (e.g., tympanostomy 69436 and echocardiography 93303/93306), the profile suggests the provider delivers a mix of procedural, diagnostic, and acute care pediatric services under its Medicaid population.

Competitive standing within the state is strong and concentrated: multiple codes are reported as extreme outliers or in very high percentiles (examples include 99283 at the 99th percentile and rank #3, 0241U and 0240U both rank #1 of their peer sets at the 100th percentile), which characterizes this provider as a dominant in‑state pediatric hub for several outpatient, ED, testing, and preventive codes. At the same time, several other high-revenue codes are listed as “typical, unremarkable” in percentile despite large absolute dollars, indicating the provider combines some market-dominant lines with other high-volume services that are more common among peers.

The organization is an established participant in the market: the NPI was enumerated on 2006-09-21 (~20 years ago). That tenure, combined with the concentrated revenue base and multiple top-rank positions, supports the interpretation of an experienced, large pediatric provider with entrenched ED, outpatient clinic, testing, and well-child service lines within the Minnesota Medicaid ecosystem.

Medicaid: Complete Services Breakdown

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

226 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	188,630	$180	$33.2M
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.	66,250	$280	$18.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	161,080	$100	$15.5M
0241U	N/A	49,660	$130	$6.7M
J1100	Injection, dexamethasone sodium phosphate, 1 mg	7,710	$480	$3.7M
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	2,670	$1,120	$3M
0240U	N/A	13,120	$140	$1.8M
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…	20,810	$70	$1.5M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	20,560	$70	$1.4M
C9803	Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	52,930	$20	$1.1M

Showing 1–10 of 226

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Minnesota Distribution

Childrens Health Care — 13 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. Minnesota median

226 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	8	80	6,550	$80	$4.4M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	6	10	1,690	$300	$2.4M
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.	142	160	580	$170	$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.	8	210	980	$140	$1.7M
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.	3	220	1,730	$120	$1.3M
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…	68	110	1,880	$50	$564.6K
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…	623	1,200	1,030	$70	$549.7K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	537	1,140	1,010	$100	$543K
D2930	N/A	5	70	610	$170	$518.6K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	112	260	890	$60	$405.3K

Showing 1–10 of 226

Related Providers

Other providers that share a Tax Identification Number (TIN) with Childrens Health Care, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Childrens Health Care	MN	Pediatrics Physician	$0	$25.4M
Childrens Health Care	MN	Emergency Care Clinic/Center	$0	$18.6M
Children's Health Care	MN	Primary Care Clinic/Center	$0	$17.3M
Day Surgery Limited Liability	WV	Ambulatory Surgical Clinic/Center	$1.1M	$569.1K
Jeffrey Peterson	GA	Diagnostic Radiology Physician	$152.3K	$0
Ferras Zeni	MN	Orthopaedic Surgery Physician	$56.8K	$0
Bjorn Engstrom	MN	Vascular & Interventional Radiology Physician	$55.7K	$0
Phillip Radke	MN	Ophthalmic Plastic and Reconstructive Surgery Physician	$50.7K	$0
Luis Carrazana Suarez	MN	Orthopaedic Surgery Physician	$48.7K	$0
Gennadiy Busel	MN	Orthopaedic Surgery Physician	$48.2K	$0

Nearby Providers

Other providers in the same ZIP code as Childrens Health Care, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nu-way House Inc	MN	Substance Abuse Rehabilitation Facility	$0	$200.8M
Midwest Home Health Care, Inc.	MN	Home Health Agency	$0	$73.5M
Midwest Quality Home Care, Inc.	MN	Home Health Agency	$0	$66.7M
Regents Of The University Of Minnesota	MN	Federally Qualified Health Center (FQHC)	$0	$55.2M
Minnesota Professional Health Services,inc	MN	Home Health Agency	$0	$51.9M
Park Ave Center Inc	MN	Substance Use Disorder Rehabilitation Clinic/Center	$0	$50.8M
Minnesota Quality Care, Inc.	MN	Home Health Agency	$0	$48.4M
Direct Home Health Care, Inc.	MN	Home Health Agency	$0	$30.7M
Aaa A-z Friendly Languages Inc	MN	Interpreter	$0	$29.4M
Comfort Services LLC	MN	Home Health Agency	$0	$29.1M

Childrens Health Care — Billing Profile & Reimbursement Data

Sign up for Childrens Health Care — Billing Profile & Reimbursement Data policy alerts

Childrens Health Care — Billing Profile & Reimbursement Data

Sign up for Childrens Health Care — Billing Profile & Reimbursement Data policy alerts

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