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.

Coastal Children's Clinic PA (NPI 1164471116)

Coastal Children's Clinic PA is a pediatrics physician provider located in Corpus Christi, Texas. This profile covers 0 Medicare and 105 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	Coastal Children's Clinic PA
Address	3435 S Alameda St
City	Corpus Christi
State	TX
ZIP	78411
Taxonomy	Pediatrics Physician
NPI Enumerated	May 8, 2006

Payer Source	Total Paid
Medicaid	$14.5M
Medicare	$0

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

105 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	25,600	$90	$2.4M
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…	24,560	$90	$2.2M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	19,690	$100	$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…	18,380	$90	$1.6M
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.	98,080	$10	$1.3M
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…	140,430	$10	$983K
99429	Use 99429 to report a preventive medicine service that does not have a specific code.	21,750	$40	$782.9K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	16,290	$40	$570K
99050	In this procedure, the provider renders services to a patient in his office at a time when that office would otherwise be closed.	4,850	$100	$479.9K
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…	7,120	$50	$377.6K

Showing 1–10 of 105

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

Coastal Children's Clinic PA — 19 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

105 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S3620	Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis;…	23	110	90	$270	$3.5M
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…	85	150	170	$30	$302.9K
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…	33	6,040	710	$40	$232.8K
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…	13	1,500	880	$80	$185.8K
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…	20	1,360	800	$80	$185.6K
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…	129	5,810	540	$50	$155.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	10	1,540	650	$80	$150.4K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	1,059	1,700	610	$80	$111.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	9	1,540	360	$80	$110.6K
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.	16	1,650	2,350	$10	$88.7K

Showing 1–10 of 105

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Driscoll Childrens Hospital	TX	Children's Hospital	$0	$133.2M
Children's Physician Services Of South Texas	TX	Pediatrics Physician	$0	$50.9M
Hub City Home Health Inc	TX	Home Health Agency	$0	$43.8M
Epic Health Services, Inc.	TX	Home Health Agency	$0	$30M
Driscoll Children's Hospital	TX	Ambulance	$0	$25.6M
Educare Community Living Corporation - Texas	TX	Community/Behavioral Health Agency	$0	$12.7M
Sacred Heart Home Health Inc.	TX	Personal Care Attendant	$0	$11.1M
X-ray On Wheels, Inc.	TX	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	$4.6M	$3.9M
Tac Med Inc.	TX	Land Ambulance	$1.6M	$2.4M
Wayne Fagan	TX	MOHS-Micrographic Surgery Physician	$708.5K	$0

Coastal Children's Clinic PA — Billing Profile & Reimbursement Data

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Coastal Children's Clinic PA — 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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