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.

Driscoll Childrens Hospital (NPI 1548286172)

Key Findings

Field	Value
Entity Type	Organization
Organization	Driscoll Childrens Hospital
Address	3533 South Alameda Street
City	Corpus Christi
State	TX
ZIP	78411
Taxonomy	Children's Hospital
NPI Enumerated	July 15, 2006

Payer Source	Total Paid
Medicaid	$133.2M
Medicare	$0

DRISCOLL CHILDRENS HOSPITAL is effectively a single-payer facility in the available data: it has no Medicare billing on file and reports $133.2M in lifetime Medicaid revenue, indicating Medicaid is the dominant and de facto sole public payer visible in these datasets. The lack of Medicare entries suggests the hospital operates primarily within pediatric lines of care where Medicaid is the primary payer population.

Revenue concentration is high: the platform notes the top three Medicaid codes by revenue account for 34.7% of the provider’s total Medicaid revenue. This indicates a relatively concentrated revenue mix where a few high-volume or high-value pediatric services drive more than one-third of Medicaid receipts, increasing sensitivity to shifts in reimbursement or utilization for those specific services.

The code mix and highest-revenue items point to core pediatric surgical, emergency, and outpatient services. High revenues are associated with office/outpatient E/M codes (99213, 99212), emergency department E/M codes (99284, 99283, 99285), and procedure-heavy entries like tympanostomy (69436) and tonsil/adenoid surgery (42820, 42830). Together these suggest the hospital runs a substantial ambulatory and ED practice for children plus a high-volume pediatric ENT and procedural surgery service line.

Several codes show the hospital is a major in-state provider by volume. For example, 99212 (60.1K claims, $10.8M) ranks #9 of 1922 providers in-state and is labeled an extreme outlier, and 99213 (59.5K claims, $15.5M) ranks #89 of 6037 providers (99th percentile). These placements indicate the hospital is a top-tier pediatric outpatient/E/M provider in Texas and substantially above typical state volumes for common office visits.

The hospital is also a notable emergency care provider for pediatric patients: 99284 (25.3K claims, $11M) ranks #75 of 714 providers (90th percentile) and 99283 (66K claims, $5M) ranks #24 of 732 providers (97th percentile). While some ED codes are described as typical for state volume, their combination with very high claim counts signals a large, busy pediatric ED that contributes materially to Medicaid revenue.

Procedural and diagnostic specialty services further support a comprehensive pediatric hospital profile. High-revenue procedural codes include 69436 tympanostomy ($6M, rank #7/125), 42820 tonsil/adenoidectomy ($5.7M, rank #6/107), and cardiac imaging such as 93303 ($5.5M, rank #22/73) and 93306 ($2.6M, rank #43/410). These ranks at or above the 70th–95th percentiles show the hospital maintains strong specialty throughput in ENT and pediatric cardiology relative to in-state peers.

Laboratory and imaging volumes are substantial and supportive of large ambulatory and inpatient throughput: high claim counts for rapid infectious testing (87804, 24.5K claims), comprehensive labs (80053, 24.1K claims), EKGs (93005, 12K claims), and newborn/diagnostic imaging (72082, 2.5K claims) collectively indicate robust ancillary service utilization that complements the hospital’s clinical volumes. These items also appear in high in-state percentiles, underscoring scale across multiple service domains.

The provider’s NPI was enumerated ~20 years ago (2006-07-15), indicating long tenure in the market. Combined with consistent high-percentile rankings across many pediatric E/M, procedural, and diagnostic codes, this longevity supports the interpretation that DRISCOLL CHILDRENS HOSPITAL is an established regional pediatric referral and care hub for Medicaid populations in Texas.

Medicaid: Complete Services Breakdown

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

241 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…	59,460	$260	$15.5M
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.	25,290	$440	$11M
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,…	60,110	$180	$10.8M
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…	51,390	$150	$7.7M
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	24,150	$260	$6.3M
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	2,520	$2,400	$6M
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	1,230	$4,620	$5.7M
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…	2,940	$1,890	$5.5M
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.	65,960	$80	$5M
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	34,180	$120	$4.2M

Showing 1–10 of 241

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

Driscoll Childrens Hospital — 10 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

241 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.	75	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.	69	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.	24	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.	131	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…	53	1,350	1,860	$80	$872.4K
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.	24	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…	22	70	850	$180	$621.2K
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…	47	340	400	$50	$553.5K
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,…	23	60	340	$590	$491.5K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	6	110	80	$1,260	$398.1K

Showing 1–10 of 241

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
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
Coastal Children's Clinic PA	TX	Pediatrics Physician	$0	$14.5M
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
Nathan Davis	TX	Dermatology Physician	$527.1K	$0

Driscoll Childrens Hospital — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References