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 Physician Network (NPI 1669442042)

Cook Children's Physician Network is a pediatric emergency medicine (emergency medicine) physician provider located in Fort Worth, Texas. This profile covers 0 Medicare and 18 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 Physician Network
Address	801 7th Ave
City	Fort Worth
State	TX
ZIP	76104
Taxonomy	Pediatric Emergency Medicine (Emergency Medicine) Physician
NPI Enumerated	January 26, 2006

Payer Source	Total Paid
Medicaid	$25.7M
Medicare	$0

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

18 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.	106,220	$90	$9.8M
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.	74,690	$110	$8.5M
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.	129,570	$50	$6.3M
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	3,110	$210	$659.3K
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.	6,820	$30	$225.1K
99281	The provider sees a patient for the lowest level emergency department visit.	5,220	$20	$88.7K
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…	490	$60	$29.8K
99292	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	90	$170	$15.5K
99205	The provider sees a new 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 provider…	160	$70	$10.8K
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…	110	$40	$4K

Showing 1–10 of 18

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 Physician Network — 4 of 18 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

18 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.	9	710	1,790	$200	$2.1M
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.	5	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.	7	590	740	$170	$969.2K
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.	29	370	360	$120	$279.5K
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…	4,876	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…	177	210	260	$120	$221.2K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,360	1,500	880	$80	$185.8K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,235	1,360	800	$80	$185.6K
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…	4,741	5,810	540	$50	$155.5K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	22	280	190	$130	$148.6K

Showing 1–10 of 18

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 Medical Center	TX	Pediatrics Physician	$0	$21.3M
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 Physician Network — Billing Profile & Reimbursement Data

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Cook Children's Physician Network — 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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