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.

Mother Frances Hospital Regional Health Care Center (NPI 1679578439)

Field	Value
Entity Type	Organization
Organization	Mother Frances Hospital Regional Health Care Center
Address	800 E Dawson St
City	Tyler
State	TX
ZIP	75701
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 17, 2005

Payer Source	Total Paid
Medicaid	$32.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

243 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.	54,220	$190	$10.5M
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.	124,200	$50	$6.3M
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…	56,340	$50	$2.6M
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	38,490	$50	$2M
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.	5,890	$320	$1.9M
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…	25,770	$70	$1.8M
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.	39,810	$40	$1.7M
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…	7,180	$120	$847.4K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	26,800	$20	$455.5K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	860	$450	$381.8K

Showing 1–10 of 243

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

Mother Frances Hospital Regional Health Care Center — 8 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

243 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S3620	Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis;…	71	110	90	$270	$3.5M
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.	30	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.	7	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.	116	590	740	$170	$969.2K
01967	The provider performs neuraxial anesthesia services for a patient undergoing a planned vaginal delivery.	41	80	1,160	$220	$768.8K
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…	38	340	400	$50	$553.5K
G0378	Hospital observation service, per hour	41	70	300	$500	$465K
J0585	Injection, onabotulinumtoxina, 1 unit	15	20	200	$1,140	$437.7K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	79	110	80	$1,260	$398.1K
00170	The provider performs anesthesia services for a patient undergoing an intraoral procedure, including biopsy.	74	100	410	$160	$390K

Showing 1–10 of 243

Related Providers

Other providers that share a Tax Identification Number (TIN) with Mother Frances Hospital Regional Health Care Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tyler Family Circle Of Care	TX	Federally Qualified Health Center (FQHC)	$0	$48.3M
Christus Trinity Clinic Texas	TX	Family Medicine Physician	$0	$22.2M
Christus Health Ark-la-tex	TX	General Acute Care Hospital	$0	$15.6M
Natalie Alphonse Sullivan	LA	Radiation Oncology Physician	$1.9M	$0
Christopher Jordan	CO	Hematology & Oncology Physician	$970.8K	$0
Apryl Mensah	TX	Radiation Oncology Physician	$916.7K	$0
Alaa Younes	LA	Interventional Cardiology Physician	$872.9K	$0
Kannarr Eye Care, LLC	KS	Optometrist	$0	$788.4K
Jose Ortiz	TX	Endocrinology, Diabetes & Metabolism Physician	$691.3K	$0
Jared Petty	TX	Internal Medicine Physician	$609K	$0

Nearby Providers

Other providers in the same ZIP code as Mother Frances Hospital Regional Health Care Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Premier Kids Care Inc	TX	Community/Retail Pharmacy	$0	$28.2M
Pediatric Home Healthcare, LLC	TX	Home Health Agency	$0	$23.7M
Thomas Bochow	TX	Ophthalmology Physician	$3.6M	$0
Wendy Prewett	TX	Acute Care Nurse Practitioner	$2.9M	$0
Heaton Laser And Surgery Center L L C	TX	Ambulatory Surgical Clinic/Center	$2.7M	$113K
Angela Sutherland	TX	Nurse Practitioner	$2.3M	$0
Diman Lamichhane	TX	Rheumatology Physician	$2.1M	$0
Trincare Inc	TX	Clinical Medical Laboratory	$539.4K	$1.5M
Speed Of Light Xray, LLC	TX	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	$1.3M	$529.8K
Thomas Buzbee	TX	Internal Medicine Physician	$1.5M	$0

Mother Frances Hospital Regional Health Care Center — Billing Profile & Reimbursement Data

Sign up for Mother Frances Hospital Regional Health Care Center — Billing Profile & Reimbursement Data policy alerts

Mother Frances Hospital Regional Health Care Center — Billing Profile & Reimbursement Data

Sign up for Mother Frances Hospital Regional Health Care 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