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

Why is the Medicaid comparison limited to Virginia 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. Virginia (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 Hospital Of The Kings Daughters Inc (NPI 1912919481)

Field	Value
Entity Type	Organization
Organization	Childrens Hospital Of The Kings Daughters Inc
Address	601 Childrens Ln
City	Norfolk
State	VA
ZIP	23507
Taxonomy	Children's Hospital
NPI Enumerated	August 13, 2006

Payer Source	Total Paid
Medicaid	$288.2M
Medicare	$0

Key Findings

This provider is effectively single-payer at scale: there is no Medicare billing on file while Medicaid revenue totals $288.2M, indicating that Medicaid is the dominant and near-exclusive public payer for its billed services. The absence of Medicare billing suggests the organization’s patient mix, service lines, or billing arrangements are concentrated in pediatric Medicaid populations rather than traditional Medicare beneficiaries.

Revenue concentration is high and focused in a few service lines: the precomputed top three Medicaid codes (92507, 99283, 99213) together account for 33.5% of the provider’s total Medicaid revenue. Individually those codes are 92507 ($23.7M, 12.2%), 99283 ($22.2M, 11.4%), and 99213 ($19.3M, 9.9%), highlighting that a small set of high-volume E/M and specialty evaluation codes drive a third of Medicaid receipts.

The code mix aligns with a comprehensive pediatric tertiary/acute care model: 92507 shows extremely high volume (186.5K claims) and ranks #1 of 256 in-state (100th percentile; extreme outlier), while large volumes of evaluation & management codes (99283, 99213, 99214, 99212) indicate substantial emergency department and outpatient clinic throughput. Combined with high volumes for pediatric-focused procedures and diagnostics (e.g., 42820 tonsil/adenoid removal and 69436 tympanostomy), the data support an operating model that includes ED care, ambulatory clinics, surgical services, and specialty pediatric therapies.

Emergency care footprint is pronounced and statewide-leading for some ED levels: 99283 has 115.8K claims and $22.2M revenue, ranking #8 of 626 providers in-state (99th percentile; extreme outlier), and lower- and higher-acuity ED codes 99284 (35.5K claims, $10.8M) and 99285 (25.9K claims, $9.3M) also contribute materially. These volumes and ranks point to high pediatric ED throughput and capacity to manage a range of acuity levels within the state.

Ambulatory outpatient evaluation and management activity is a major revenue center: 99213 (138.8K claims, $19.3M) ranks #11 of 4012 (100th percentile; extreme outlier), 99214 (136.7K claims, $12.4M) ranks #15 of 3523 (100th percentile), and 99212 (52.6K claims, $10.5M) ranks #2 of 975 (100th percentile). This pattern indicates a large established-patient clinic population and substantial repeat outpatient visit volume billed to Medicaid.

Rehabilitation and therapy services are a significant business line: 97110 has 128K claims and $9.6M revenue (ranks #3 of 401, 100th percentile; extreme outlier) and 97530 has 109.8K claims and $7.5M revenue (ranks #2 of 401, 100th percentile; extreme outlier). These high volumes of therapeutic exercise and functional activity codes indicate extensive pediatric PT/OT programming and outpatient therapy capacity.

The provider offers broad procedural and diagnostic specialties with notable state leadership in several pediatric procedures and diagnostics: polysomnography 95810 ($4.4M) ranks #1 of 59 (100th percentile; extreme outlier), tonsil/adenoid removal 42820 ($4.3M) ranks #1 of 31 (100th percentile; extreme outlier), tympanostomy 69436 ($4M) ranks #1 of 46 (100th percentile; extreme outlier), and echocardiography codes 93306/93304 and MRI 70551 appear among high-volume imaging services. Presence of J1745 infusion activity ($4.8M, ranks #2 of 7) further signals capacity for specialty inpatient or infusion clinic services.

Competitive standing and longevity are clear: multiple high-revenue codes are in the 100th percentile or top in-state rank (many listed as extreme outlier or notably above typical state volume), supporting the interpretation that CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS INC is a dominant pediatric provider within Virginia. The NPI was enumerated 2006-08-13 (~20 years ago), indicating long tenure in the market and an established provider footprint to support the observed high-volume Medicaid billing patterns.

Medicaid: Complete Services Breakdown

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

586 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	186,500	$130	$23.7M
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.	115,760	$190	$22.2M
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…	138,790	$140	$19.3M
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…	136,700	$90	$12.4M
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.	35,500	$300	$10.8M
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	52,600	$200	$10.5M
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…	128,000	$80	$9.6M
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.	25,950	$360	$9.3M
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.	109,760	$70	$7.5M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	39,790	$180	$7M

Showing 1–10 of 586

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

Childrens Hospital Of The Kings Daughters Inc — 19 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

586 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J1569	Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg	2	10	3,260	$1,870	$6.1M
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.	37	90	9,030	$280	$3.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	68	70	3,200	$110	$2.8M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	2	10	800	$1,530	$2.1M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	2	30	600	$1,370	$1.7M
S9083	Global fee urgent care centers	9	20	150	$100	$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	340	160	$130	$1.3M
J2357	Injection, omalizumab, 5 mg	6	10	830	$990	$1.2M
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.	8	630	90	$140	$1.1M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	3	140	3,240	$160	$1M

Showing 1–10 of 586

Related Providers

Other providers that share a Tax Identification Number (TIN) with Childrens Hospital Of The Kings Daughters Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Medical Center Radiologists Inc	VA	Diagnostic Radiology Physician	$0	$13.7M
Childrens Hospital Of The Kings Daughters Inc	VA	Adolescent and Children Mental Health Clinic/Center	$0	$10.2M
Childrens Hospital Of The Kings Daughters Inc	VA	Pediatrics Physician	$0	$8.4M

Nearby Providers

Other providers in the same ZIP code as Childrens Hospital Of The Kings Daughters Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sentara Hospitals	VA	General Acute Care Hospital	$0	$88M
Childrens Specialty Group PLLC	VA	Pediatrics Physician	$0	$87.7M
Sentara Reference Lab Solutions, LLC	VA	Clinical Medical Laboratory	$12.9M	$4.7M
Jonathan Wiesen	VA	Internal Medicine Physician	$2.4M	$0
Deepak Deshmukh	VA	Vascular Surgery Physician	$1.4M	$0
Sentara Hospitals	VA	Air Ambulance	$977.3K	$170.6K
Edwin Crandley	VA	Radiation Oncology Physician	$315.3K	$0
James Post	VA	Anatomic Pathology & Clinical Pathology Physician	$211.2K	$4.7K
Yi Wang	VA	Anatomic Pathology & Clinical Pathology Physician	$201.2K	$0
Sandeep Garg	VA	Vascular & Interventional Radiology Physician	$176.1K	$0

Childrens Hospital Of The Kings Daughters Inc — Billing Profile & Reimbursement Data

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Childrens Hospital Of The Kings Daughters 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

Related Providers

Nearby Providers

Frequently Asked Questions

References