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.

Privia Medical Group Gulf Coast, PLLC (NPI 1578969465)

Field	Value
Entity Type	Organization
Organization	Privia Medical Group Gulf Coast, PLLC
Address	7900 Fannin St Ste 4000
City	Houston
State	TX
ZIP	77054
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	November 5, 2014

Payer Source	Total Paid
Medicaid	$11.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

225 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…	87,260	$30	$2.7M
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…	56,280	$40	$2.2M
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	2,160	$540	$1.2M
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	3,270	$90	$303.6K
59430	For this service, the provider or nonphysician healthcare professional provides care to the patient in the outpatient setting following the delivery. Routine postpartum care can involve one or more…	3,210	$80	$247.4K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	860	$270	$232.5K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	3,460	$70	$225K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	8,090	$30	$202.3K
59514	The provider admits the patient to the hospital for delivery, delivers the fetus and placenta via an abdominal incision, and provides care immediately after delivery on the same date of service. This…	320	$620	$198.4K
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…	3,070	$60	$196.7K

Showing 1–10 of 225

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

Privia Medical Group Gulf Coast, PLLC — 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

225 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J1745	Injection, infliximab, excludes biosimilar, 10 mg	4	10	140	$5,060	$799.6K
81513	The lab analyst performs the technical lab test on a vaginal fluid specimen for quantitative real–time amplification of RNA markers for three bacterial species listed in the code descriptor, and…	10	30	410	$70	$363.5K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	11	270	130	$570	$318.8K
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…	29	150	170	$30	$302.9K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	31	120	310	$220	$302.6K
81514	The lab analyst performs the technical lab tests on a vaginal fluid specimen for quantitative real–time amplification of DNA markers for six bacterial species listed in the code descriptor, and…	7	20	290	$100	$269K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	178	370	550	$80	$249.6K
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…	53	6,040	710	$40	$232.8K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	28	290	410	$20	$225K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	29	300	410	$20	$223.4K

Showing 1–10 of 225

Related Providers

Other providers that share a Tax Identification Number (TIN) with Privia Medical Group Gulf Coast, PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Igor Cherches	TX	Neurology Physician	$6.7M	$0
Carmen Perez-masuelli	TX	Rheumatology Physician	$1.8M	$0
Christopher Nguyen	TX	Interventional Cardiology Physician	$1.7M	$0
Samer Suki	TX	Hematology & Oncology Physician	$1.7M	$0
Umang Patel	TX	Radiation Oncology Physician	$1.1M	$0
Mohsen Arani	TX	Hematology & Oncology Physician	$1M	$0
Shan Guo	TX	Hematology & Oncology Physician	$938.6K	$0
Pierre Khoury	TX	Hematology & Oncology Physician	$589.1K	$0
Urmeel Patel	TX	Hematology & Oncology Physician	$570.6K	$0
Nena Mirkovic	TX	Radiation Oncology Physician	$536.7K	$0

Nearby Providers

Other providers in the same ZIP code as Privia Medical Group Gulf Coast, PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tcg Interests, LLC	TX	Durable Medical Equipment & Medical Supplies	$0	$52.4M
Texas Quality One Medical Services Inc.	TX	Personal Care Attendant	$0	$31.7M
Siblings Healthcare Solutions LLC	TX	Home Health Agency	$0	$19.7M
National Seating & Mobility, Inc.	TX	Durable Medical Equipment & Medical Supplies	$0	$17.7M
Option Care Enterprises, Inc.	TX	Home Infusion Therapy Pharmacy	$0	$13.8M
Optimal In Home Care Inc.	TX	Personal Care Attendant	$0	$13.6M
United Seating And Mobility LLC	TX	Durable Medical Equipment & Medical Supplies	$0	$11.6M
Access Dx Laboratory LLC	TX	Clinical Medical Laboratory	$458.3K	$4.3M
Ignacio Valdes	TX	Psychiatry Physician	$404.4K	$2.1M
Orion Ambulance Service LLC	TX	Land Ambulance	$1.8M	$476.7K

Privia Medical Group Gulf Coast, PLLC — Billing Profile & Reimbursement Data

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Privia Medical Group Gulf Coast, PLLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References