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.

Methodist Children's Hospital (NPI 1437171568)

Field	Value
Entity Type	Organization
Organization	Methodist Children's Hospital
Address	4015 22nd Place
City	Lubbock
State	TX
ZIP	79410
Taxonomy	Children's Hospital
NPI Enumerated	July 25, 2006

Payer Source	Total Paid
Medicaid	$12.7M
Medicare	$0

Medicaid: Complete Services Breakdown

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

145 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	8,420	$350	$2.9M
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.	25,310	$90	$2.2M
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	3,340	$410	$1.4M
G0378	Hospital observation service, per hour	1,860	$550	$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.	1,850	$530	$978.9K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	380	$1,450	$547.7K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	3,530	$80	$279K
99281	The provider sees a patient for the lowest level emergency department visit.	3,210	$80	$253.2K
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…	19,550	$10	$234.5K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	70	$2,900	$208.6K

Showing 1–10 of 145

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

Methodist Children's Hospital — 1 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

145 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.	191	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.	34	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.	78	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.	214	590	740	$170	$969.2K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	898	1,350	1,860	$80	$872.4K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	290	340	400	$50	$553.5K
G0378	Hospital observation service, per hour	13	70	300	$500	$465K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	60	110	80	$1,260	$398.1K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	635	1,620	1,070	$70	$333.5K
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…	103	150	170	$30	$302.9K

Showing 1–10 of 145

Nearby Providers

Other providers in the same ZIP code as Methodist Children's Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Covenant Medical Group	TX	Family Medicine Physician	$0	$34.3M
Joseph Wolcott	TX	Undersea and Hyperbaric Medicine (Preventive Medicine) Physician	$3.1M	$0
Lubbock Surgery Center, LLC	TX	Ambulatory Surgical Clinic/Center	$2.9M	$6.9K
Jesus Hidalgo	TX	Surgery Physician	$2.3M	$0
Brent Paulger	TX	Dermatology Physician	$758.8K	$0
Juan Kurdi	TX	Interventional Cardiology Physician	$739.1K	$0
Richard Hope	TX	Dermatology Physician	$697.8K	$0
South Plains Endoscopy Center	TX	Endoscopy Clinic/Center	$679K	$0
Ayman Karkoutly	TX	Cardiovascular Disease Physician	$660.2K	$0
Keith Wisniewski	TX	Dermatology Physician	$655.1K	$0

Methodist Children's Hospital — Billing Profile & Reimbursement Data

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Methodist Children's Hospital — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References