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.

Cook Children's Medical Center (NPI 1396188074)

Cook Children's Medical Center is a pediatrics physician provider located in Fort Worth, Texas. This profile covers 0 Medicare and 38 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	Cook Children's Medical Center
Address	1401 W Pulaski St
City	Fort Worth
State	TX
ZIP	76104
Taxonomy	Pediatrics Physician
NPI Enumerated	April 11, 2013

Payer Source	Total Paid
Medicaid	$21.3M
Medicare	$0

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

38 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…	145,060	$50	$7.4M
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…	89,940	$50	$4.6M
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	38,250	$80	$3.1M
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…	36,880	$80	$2.8M
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	59,880	$30	$1.7M
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…	14,200	$80	$1.1M
87634	The lab analyst performs a test for respiratory syncytial virus (RSV) antigen detection using amplified nucleic acid probe technique.	3,710	$50	$192.8K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	9,220	$20	$165.9K
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…	1,100	$120	$134.4K
74018	Report this code for one X–ray view of the structures and organs in the abdomen to diagnose certain abdominal problems.	4,760	$20	$81K

Showing 1–10 of 38

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

Cook Children's Medical Center — 9 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

38 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A4353	Intermittent urinary catheter, with insertion supplies	24	40	1,010	$540	$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…	30	6,040	710	$40	$232.8K
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…	63	5,810	540	$50	$155.5K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	1	350	230	$70	$120.3K
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…	2	850	260	$40	$77.5K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	2	420	340	$20	$73.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	1,864	1,920	220	$30	$65.9K
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…	15	1,860	130	$70	$65.4K
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…	182	1,520	100	$80	$50.1K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	1,365	1,850	510	$10	$48.3K

Showing 1–10 of 38

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cook Children's Medical Center	TX	Children's Hospital	$0	$286.6M
Cook Children's Physician Network	TX	Pediatrics Physician	$0	$106.2M
Cook Children's Physician Network	TX	Pediatric Emergency Medicine (Emergency Medicine) Physician	$0	$25.7M
Allaaddin Mollabashy	TX	Orthopaedic Surgery Physician	$170K	$0
Nathan Gilbert	TX	Orthopaedic Surgery Physician	$100.2K	$0
Andrea Armstrong	TX	Family Nurse Practitioner	$22K	$0
Scott Pilgrim	TX	Adult Congenital Heart Disease Physician	$2.4K	$0
Bradley Maddy	TX	Physician Assistant	$910	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cook Childrens Home Health	TX	Durable Medical Equipment & Medical Supplies	$0	$64.4M
Tarrant County Hospital District	TX	General Acute Care Hospital	$0	$61.8M
Acclaim Physician Group, Inc	TX	Internal Medicine Physician	$0	$30.9M
Texas Health Harris Methodist Hospital Fort Worth	TX	General Acute Care Hospital	$0	$13.8M
James Haden	TX	Allergy & Immunology (Internal Medicine) Physician	$819.3K	$2.5M
Physicians Surgical Center Of Ft. Worth LLP	TX	Ambulatory Surgical Clinic/Center	$2.9M	$0
Sleep Telemedicine Services, Inc	TX	Sleep Disorder Diagnostic Clinic/Center	$187.3K	$2M
Matthew Cavey	TX	Radiation Oncology Physician	$1.9M	$0
Surgical Caregivers Of Fort Worth LLC	TX	Ambulatory Surgical Clinic/Center	$1.2M	$1.3K
Harshal Broker	TX	Vascular Surgery Physician	$1.2M	$0

Cook Children's Medical Center — Billing Profile & Reimbursement Data

Sign up for Cook Children's Medical Center — Billing Profile & Reimbursement Data policy alerts

Cook Children's Medical Center — Billing Profile & Reimbursement Data

Sign up for Cook Children's Medical Center — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References