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 1932208808)

Childrens Health Care is a pediatrics physician provider located in Minneapolis, Minnesota. This profile covers 0 Medicare and 88 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

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

Payer Source	Total Paid
Medicaid	$25.4M
Medicare	$0

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

88 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	65,360	$60	$3.9M
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…	50,960	$70	$3.7M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	25,280	$80	$2.1M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	7,810	$260	$2M
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	24,600	$80	$1.9M
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	12,370	$110	$1.3M
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	20,800	$60	$1.3M
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…	25,310	$50	$1.2M
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…	23,130	$40	$925.2K
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	3,460	$250	$854.9K

Showing 1–10 of 88

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 — 15 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

88 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	186	220	1,730	$120	$1.3M
T1013	Sign language or oral interpretive services, per 15 minutes	152	210	560	$60	$822.1K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	7	120	400	$60	$685.8K
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…	84	1,180	1,150	$80	$605.7K
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…	95	1,200	1,030	$70	$549.7K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	10	100	250	$100	$399.5K
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	1	10	700	$270	$357.1K
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	1	10	560	$260	$336.5K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	18	170	620	$40	$333K
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	1	10	1,400	$80	$285.5K

Showing 1–10 of 88

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Childrens Health Care	MN	Children's Hospital	$0	$100M
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

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

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Childrens Health Care — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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