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

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

United Regional Health Care System Inc (NPI 1023013448)

United Regional Health Care System Inc is a general acute care hospital provider located in Wichita Falls, Texas. This profile covers 0 Medicare and 163 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	United Regional Health Care System Inc
Address	1600 11th St
City	Wichita Falls
State	TX
ZIP	76301
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 14, 2005

Payer Source	Total Paid
Medicaid	$21.1M
Medicare	$0

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

163 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	18,310	$420	$7.7M
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.	22,350	$330	$7.3M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	600	$1,430	$854.1K
U0004	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…	6,140	$110	$699.6K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	12,260	$50	$612.9K
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.	12,670	$50	$608K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	31,600	$10	$379.2K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	34,690	$10	$346.9K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	1,690	$160	$270.1K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	1,310	$200	$265K

Showing 1–10 of 163

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Texas Distribution

United Regional Health Care System Inc — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. Texas median

163 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	85	710	1,790	$200	$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.	28	70	370	$760	$1M
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.	157	730	1,960	$100	$1M
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.	42	590	740	$170	$969.2K
G0378	Hospital observation service, per hour	29	70	300	$500	$465K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	76	120	340	$120	$422K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	88	110	80	$1,260	$398.1K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	25	160	200	$110	$323.8K
U0004	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…	18	100	470	$50	$319.1K
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	117	150	170	$30	$302.9K

Showing 1–10 of 163

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Venkat Thota	TX	Cardiovascular Disease Physician	$580K	$0
Andre Desire	TX	Interventional Cardiology Physician	$464.3K	$0
Ved Ganeshram	TX	Cardiovascular Disease Physician	$432K	$0
Bruce Palmer	TX	Interventional Cardiology Physician	$377.2K	$0
Soe-ni Kong	TX	Interventional Cardiology Physician	$367.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
North Central Texas Community Health Care Center, Inc	TX	Federally Qualified Health Center (FQHC)	$0	$12.3M
Danny Bartel	TX	Neurology Physician	$4.4M	$0
Praveen Reddy	TX	Hematology & Oncology Physician	$1.8M	$0
Shehzadi Nagra	TX	Infectious Disease Physician	$1.4M	$770
Texoma Outpatient Surgery Center, Inc.	TX	Ambulatory Surgical Clinic/Center	$1.1M	$650
Wichita Falls Endoscopy Center	TX	Ambulatory Surgical Clinic/Center	$788.2K	$58K
Ashvinkumar Patel	TX	Nephrology Physician	$792.6K	$0
Sanjoy Sundaresan	TX	Neurological Surgery Physician	$779.8K	$0
Jordan Terasaki	TX	Pulmonary Disease Physician	$526.6K	$0
David Sabine	TX	Psychologist	$188.8K	$316.9K

United Regional Health Care System Inc — 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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