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

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

Edwards Health Care Services, Inc. (NPI 1962731570)

Field	Value
Entity Type	Organization
Organization	Edwards Health Care Services, Inc.
Address	9400 Williamsburg Plz
City	Louisville
State	KY
ZIP	40222
Taxonomy	Durable Medical Equipment & Medical Supplies
NPI Enumerated	December 10, 2009

Payer Source	Total Paid
Medicaid	$81.9M
Medicare	$0

Key Findings

EDWARDS HEALTH CARE SERVICES, INC. is effectively a single-payer Medicaid supplier: it has no Medicare billing on file and reports $81.9M in total Medicaid revenue. This concentrated payer mix means Medicaid drives the entirety of observed programmatic activity for this NPI rather than a split Medicare/Medicaid business model.

Revenue is highly concentrated in a few commodity lines: the provider's top three Medicaid codes (A9276, E0784, A4230) account for 78.9% of its total Medicaid revenue. Individually, A9276 accounts for $32.5M (39.7%), E0784 for $18.8M (22.9%), and A4230 for $13.3M (16.3%) of Medicaid revenue, indicating reliance on a narrow set of high-volume/high-value DME items.

The code mix clearly identifies a diabetes-focused DME operation: large volumes and revenue appear for CGM-related codes (A9276 sensor, A9277 transmitter, A9278 receiver, A4239 supply allowance, K0553 supply allowance) alongside insulin-pump items and infusion supplies (E0784 external ambulatory infusion pump, A4230 infusion sets, A4232 syringes). This combination of sensors, transmitters/receivers, pump hardware, and recurring consumables is consistent with a supplier that provisions full diabetes device systems and ongoing supply programs.

For its top Medicaid codes the provider appears to be the only in-state biller in the dataset: A9276, E0784, and A4230 each "rank #1 of 1 providers in-state (0th percentile; no state peer volume comparison available)." That ranking implies EDWARDS is the sole in-state Medicaid source captured for several principal product lines rather than one of many competing suppliers.

Several codes show extreme within-state concentration and unusual percentile signals: A4239 "ranks #1 of 5 providers in-state (100th percentile; notably above typical state volume for this code)", while K0553, A5120 and K0554 each "rank #1" at the 100th percentile with labels indicating typical or unremarkable state volume for those specific codes. These labels suggest the provider dominates certain supply categories relative to the available state peer set, and that some lines are notably above typical state volume.

Payment-per-claim and volume profile vary across the top items: A9276 moved 101.8K claims with an average paid/claim of $319, E0784 moved 29.2K claims at $642 avg paid/claim, and A4230 moved 95.9K claims at $139 avg paid/claim. The pattern shows a mix of very high-volume, mid-priced items (A9276, A4230) combined with fewer but higher-paid device claims (E0784), consistent with a business supplying both recurring consumables and capital-equipment items.

The provider's catalog also contains many lower-paid recurring supply codes consistent with a consumables/replacement model: A4232 (110.7K claims, $33 avg paid/claim, $3.7M revenue), A4231 (15.2K claims, $123 avg paid/claim, $1.9M revenue), and A4239 (13.6K claims, $71 avg paid/claim, $962.3K revenue) are examples that together support an ongoing revenue stream beyond one-time device sales. This mix implies ongoing customer engagement and refill/replenishment revenue in addition to initial device provisioning.

EDWARDS has an established enrollment history (NPI enumerated 2009-12-10, ~17 years ago), which, combined with concentrated Medicaid revenue and sole-provider in-state rankings for key diabetes DME codes, suggests a longstanding, specialized supplier role in Kentucky's Medicaid market rather than a new or diversified multi-payer DME entrant.

Medicaid: Complete Services Breakdown

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

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
A9276	Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply	101,790	$320	$32.5M
E0784	External ambulatory infusion pump, insulin	29,230	$640	$18.8M
A4230	Infusion set for external insulin pump, non needle cannula type	95,910	$140	$13.3M
A9277	Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system	15,040	$490	$7.3M
A4232	Syringe with needle for external insulin pump, sterile, 3 cc	110,670	$30	$3.7M
A4231	Infusion set for external insulin pump, needle type	15,230	$120	$1.9M
A9278	Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system	2,900	$370	$1.1M
A4239	Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service	13,550	$70	$962.3K
K0553	Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service	21,450	$40	$815.1K
A6257	Transparent film, sterile, 16 sq. in. or less, each dressing	32,450	$20	$681.3K

Showing 1–10 of 21

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Edwards Health Care Services, Inc. — 6 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

21 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A9276	Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply	1	10	101,790	$320	$32.4M
E0784	External ambulatory infusion pump, insulin	1	10	29,230	$640	$18.8M
A4230	Infusion set for external insulin pump, non needle cannula type	1	10	95,910	$140	$13.4M
A9277	Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system	1	10	15,040	$490	$7.3M
A4232	Syringe with needle for external insulin pump, sterile, 3 cc	1	10	110,670	$30	$3.7M
A4231	Infusion set for external insulin pump, needle type	1	10	15,230	$120	$1.9M
A9278	Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system	1	10	2,900	$370	$1.1M
A6257	Transparent film, sterile, 16 sq. in. or less, each dressing	1	10	32,450	$20	$679.4K
A9274	External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories	1	10	920	$360	$329.5K
K0553	Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service	1	10	1,160	$40	$291.5K

Showing 1–10 of 21

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Edwards Health Care Services, Inc.	OH	Durable Medical Equipment & Medical Supplies	$0	$149.9M
Edwards Health Care Services, Inc.	NC	Durable Medical Equipment & Medical Supplies	$0	$35.2M
Edwards Health Care Services, Inc.	SC	Durable Medical Equipment & Medical Supplies	$0	$2.4M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kyppec,inc	KY	Pediatric Skilled Nursing Facility	$0	$109.1M
Cedar Lake Residences, Inc.	KY	Developmentally Disabled Services Day Training Agency	$0	$27M
Milestones Services LLC	KY	Developmentally Disabled Services Day Training Agency	$0	$6.3M
Killer Bees LLC	KY	Ambulatory Surgical Clinic/Center	$2.3M	$2.2M
Kids Dentistree - Westport Village	KY	Pediatric Dentistry	$0	$4.2M
Abundant Hope Counseling Services, LLC	KY	Mental Health Counselor	$0	$3M
Heartland Diagnostics, LLC	KY	Radiology Clinic/Center	$586.9K	$0
Larry Zhou	KY	Interventional Pain Medicine Physician	$323.9K	$52.3K
Michael Cronen	KY	Pain Medicine (Anesthesiology) Physician	$307.9K	$0
Lee Goldstein	KY	Podiatrist	$220.3K	$0

Edwards Health Care Services, Inc. — Billing Profile & Reimbursement Data

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Edwards Health Care Services, 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