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

Why is the Medicaid comparison limited to Colorado 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. Colorado (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 Denver Health Care Center Inc (NPI 1962516989)

Field	Value
Entity Type	Organization
Organization	Shield Denver Health Care Center Inc
Address	2450 Airport Blvd Unit H
City	Aurora
State	CO
ZIP	80011
Taxonomy	Parenteral & Enteral Nutrition Supplies (DME)
NPI Enumerated	August 18, 2006

Payer Source	Total Paid
Medicaid	$63.3M
Medicare	$0

Key Findings

SHIELD DENVER HEALTH CARE CENTER INC reports $63.3M in lifetime Medicaid revenue and has none for Medicare on file, making it effectively a single-payer Medicaid-focused DME supplier in available claims data. The absence of Medicare billing means analyses of its market position should be framed solely against Colorado Medicaid activity rather than dual-payer comparisons.

Revenue is concentrated in a small set of Medicaid codes: the precomputed top three Medicaid codes account for 29.8% of this provider's total Medicaid revenue, led by A4554 ($6.3M, 11.5%), T4526 ($5.2M, 9.4%), and T4527 ($4.8M, 8.8%). This concentration indicates a material reliance on a few high-volume product lines for a large share of overall Medicaid receipts.

The provider’s code mix points to a business model centered on high-volume consumable DME, primarily adult incontinence supplies and enteral nutrition. High-revenue incontinence and pad/protective underwear codes (A4554, T4526, T4527, T4535, T4528) together with multiple enteral formula codes (B4160, B4161, B4150, B4154) suggest operations that supply recurrent disposable products and tube-feeding nutrition rather than predominantly durable medical equipment.

SHIELD is a dominant statewide supplier for many of its top Medicaid codes: A4554, T4526, T4527, T4535, A4927, T4528, B4150, T4522 and several others rank #1 in Colorado and are labeled extreme outliers, placing the provider at the 100th percentile for those lines. Those #1 rankings and extreme outlier designations indicate this provider substantially outpaces typical state volume for multiple product categories and likely captures a leading share in those niches.

Not all high-revenue enteral items are statistical outliers: B4160 ($4.7M, ranked #2 of 22, 95th percentile), B4161 ($3M, ranked #3 of 14, 85th percentile), and B4035 ($1.9M, ranked #5 of 22, 81th percentile) appear as high-volume but more typical state-level activity for enteral nutrition supplies. This mix shows the provider blends truly dominant positions in incontinence consumables with strong—but not abnormal—participation in several enteral supply categories.

Claim volumes and unitizations further reinforce a consumables-focused operation: examples include A4927 (177K claims, $2.5M revenue), A4554 (123.6K claims, $6.3M revenue), and T4535 (64.9K claims, $3M revenue). These very large claim counts for low-unit items are consistent with frequent, recurring shipments to end users or institutional customers rather than one-time durable equipment sales.

The business is highly exposed to policy or reimbursement changes for a compact set of product codes given the revenue concentration in incontinence-related items and a small number of enteral formulas. Any shifts in Medicaid coverage, prior authorization, or rate-setting for A4554/T4526/T4527 and other top lines could meaningfully affect overall revenue given the top-three codes account for 29.8% of Medicaid receipts.

SHIELD’s NPI was enumerated on 2006-08-18 (~20 years ago), indicating a long tenure in the market that may have enabled scale in supply-chain logistics and payer relationships within Colorado Medicaid. Tenure combined with repeated #1 state rankings for multiple codes suggests established operational capacity in high-volume DME distribution to the Medicaid population.

Medicaid: Complete Services Breakdown

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

103 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
A4554	Disposable underpads, all sizes	123,620	$50	$6.3M
T4526	Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each	44,900	$120	$5.2M
T4527	Adult sized disposable incontinence product, protective underwear/pull-on, large size, each	37,540	$130	$4.8M
B4160	Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals,…	19,650	$240	$4.7M
B4161	Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding…	4,240	$710	$3M
T4535	Disposable liner/shield/guard/pad/undergarment, for incontinence, each	64,920	$50	$3M
T4534	Youth sized disposable incontinence product, protective underwear/pull-on, each	16,730	$170	$2.9M
A4927	Gloves, non-sterile, per 100	176,950	$10	$2.5M
T4528	Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each	20,030	$120	$2.5M
B4150	Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100…	40,250	$50	$2M

Showing 1–10 of 103

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Shield Denver Health Care Center Inc — 20 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

103 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
B4161	Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding…	3	10	1,430	$720	$3.4M
K0553	Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service	4	10	2,620	$520	$3.2M
B4160	Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals,…	2	20	2,100	$310	$2.6M
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	5	20	2,840	$230	$1.8M
B4149	Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral…	7	10	1,400	$340	$1.4M
B4153	Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral…	9	10	670	$450	$1.1M
B9998	Noc for enteral supplies	3	10	4,710	$80	$1M
A4239	Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service	4	10	70	$180	$1M
B4155	Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium…	6	20	840	$310	$871K
T4527	Adult sized disposable incontinence product, protective underwear/pull-on, large size, each	1	40	2,280	$150	$795.4K

Showing 1–10 of 103

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Support, Inc.	CO	Developmentally Disabled Services Day Training Agency	$0	$111.8M
United Seating And Mobility LLC	CO	Durable Medical Equipment & Medical Supplies	$0	$58.6M
Total Longterm Care, Inc.	CO	PACE Provider Organization	$0	$22.5M
Mile High Psychiatry LLC	CO	Psychiatric/Mental Health Nurse Practitioner	$0	$18.8M
Kids Choice Dental Of Aurora PC	CO	General Practice Dentistry	$0	$18.4M
Everest Home Care LLC	CO	Home Health Agency	$0	$15.8M
Children's Hospital Colorado	CO	Dental Clinic/Center	$0	$12.9M
Shared Touch, Inc.	CO	Home Health Agency	$0	$12.6M
Shalom Family Inc.	CO	Durable Medical Equipment & Medical Supplies	$0	$12.5M
Little's Loving Home Services, Inc	CO	Home Health Agency	$0	$8.5M

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

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Shield Denver 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