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.

Scott & White Clinic (NPI 1093779704)

Scott & White Clinic is a internal medicine physician provider located in Temple, Texas. This profile covers 0 Medicare and 294 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	Scott & White Clinic
Address	2401 S 31st St
City	Temple
State	TX
ZIP	76508
Taxonomy	Internal Medicine Physician
NPI Enumerated	April 12, 2006

Payer Source	Total Paid
Medicaid	$45.6M
Medicare	$0

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

294 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	314,590	$30	$10.1M
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…	171,450	$40	$7.2M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	41,550	$80	$3.2M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	46,190	$70	$3.1M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	26,770	$80	$2.1M
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	120,940	$10	$1.3M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	14,090	$90	$1.2M
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…	15,310	$70	$1M
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	8,180	$110	$932.1K
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.	2,620	$310	$810.8K

Showing 1–10 of 294

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

Scott & White Clinic — 15 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

294 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	16	30	1,410	$340	$2.5M
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.	139	710	1,790	$200	$2.1M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	13	30	3,360	$120	$1.2M
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.	9	30	1,140	$370	$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.	199	730	1,960	$100	$1M
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	18	40	1,860	$110	$997.5K
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.	189	590	740	$170	$969.2K
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	14	30	330	$1,020	$750.2K
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	19	70	850	$180	$621.2K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	26	60	340	$590	$491.5K

Showing 1–10 of 294

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Scott & White Memorial Hospital	TX	General Acute Care Hospital	$0	$55.1M
Acclaim Physician Group, Inc	TX	Internal Medicine Physician	$0	$30.9M
Robyn Olney	TX	Anatomic Pathology & Clinical Pathology Physician	$7.7M	$0
Brian Ransdell	TX	MOHS-Micrographic Surgery Physician	$785.5K	$0
Joshua Gordon	OK	Anesthesiology Physician	$514.6K	$0
Jorge De La Chapa	TX	Ophthalmology Physician	$513K	$0
Bradley Evanson	UT	Dermatology Physician	$465.7K	$0
Michael Magee	TN	Retina Specialist (Ophthalmology) Physician	$458.1K	$0
Syed Jaffery	TX	Pain Medicine (Anesthesiology) Physician	$373.5K	$0
William Riggs	TX	Ophthalmology Physician	$360.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nilan Naik	TX	Radiation Oncology Physician	$906.8K	$0
Matthew Jepson	TX	Internal Medicine Physician	$361.6K	$0
Johnny Ross	TX	Physical Medicine & Rehabilitation Physician	$322.1K	$0
Jeffrey Knabe	TX	Orthopaedic Surgery Physician	$284K	$0
Gregory Stenoien	TX	Diagnostic Radiology Physician	$275.1K	$0
Daniel Dubose	TX	Anesthesiology Physician	$242.1K	$0
Mehul Patel	TX	Radiation Oncology Physician	$231.8K	$0
Kirby Hitt	TX	Orthopaedic Surgery Physician	$223K	$0
Mark Lawrence	TX	Interventional Cardiology Physician	$201.5K	$0
Chad Housewright	TX	MOHS-Micrographic Surgery Physician	$188.1K	$0

Scott & White Clinic — 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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