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.

Dell Children's Medical Group (NPI 1326072943)

Dell Children's Medical Group is a pediatrics physician provider located in Austin, Texas. This profile covers 0 Medicare and 103 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	Dell Children's Medical Group
Address	1301 Barbara Jordan Blvd Ste 200
City	Austin
State	TX
ZIP	78723
Taxonomy	Pediatrics Physician
NPI Enumerated	July 10, 2006

Payer Source	Total Paid
Medicaid	$11.1M
Medicare	$0

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
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…	49,830	$50	$2.6M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	17,790	$60	$1.1M
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…	18,770	$40	$732.1K
99204	The provider sees a new 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 provider…	7,300	$100	$693.8K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	11,090	$50	$532.3K
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…	6,420	$80	$500.7K
99203	The provider sees a new 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 provider…	7,510	$60	$480.4K
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…	3,560	$130	$477K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	3,180	$110	$337K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	1,530	$180	$270K

Showing 1–10 of 103

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

Dell Children's Medical Group — 8 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

103 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	22	30	1,140	$370	$1.2M
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.	10	30	330	$1,020	$750.2K
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,…	9	60	340	$590	$491.5K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	9	110	80	$1,260	$398.1K
95720	A physician or other QHCP reviews recorded events and analyzes spike and seizure detection of a continuous electroencephalography, a study of the electrical activity of the brain. A video is…	8	20	390	$170	$271.2K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	303	370	550	$80	$249.6K
95812	Electroencephalogram or EEG is a diagnostic test that uses small electrodes attached to the scalp to measure the electrical activity of the brain. Extended monitoring is a routine…	11	20	250	$230	$249.2K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	11	130	150	$370	$240.6K
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…	417	6,040	710	$40	$232.8K
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…	19	210	260	$120	$221.2K

Showing 1–10 of 103

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ascension Seton	TX	Children's Hospital	$0	$29.4M
Akbar Hussaini	TX	Orthopaedic Surgery Physician	$157K	$0
Erica Hughes	TX	Pulmonary Disease Physician	$141.8K	$0
Bernard Morris	TX	Urology Physician	$104.4K	$0
Nadia Bening	TX	Psychiatry Physician	$65.5K	$0
Rebecca Blackwell	TX	Psychiatric/Mental Health Nurse Practitioner	$52.3K	$0
Dhruve Jeevan	TX	Neurological Surgery Physician	$36.8K	$0
Kirby Reed	TX	Family Nurse Practitioner	$32.5K	$0
Lan Hoang	TX	Ophthalmology Physician	$17K	$0
Amanda Sanders	TX	Nurse Practitioner	$13K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Central Texas Community Health Centers	TX	Federally Qualified Health Center (FQHC)	$0	$28.7M
Austin Regional Clinic, PA	TX	Family Medicine Physician	$0	$14.7M
Brian Leykum	TX	Podiatrist	$196.9K	$0
Jose Grijalva	TX	Psychiatry Physician	$118.3K	$0
Malcolm Duncan	TX	Psychiatric/Mental Health Nurse Practitioner	$106.7K	$0

Dell Children's Medical Group — 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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