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.

Neonatology Consultnants Of South Texas PLLC (NPI 1700072964)

Neonatology Consultnants Of South Texas PLLC is a neonatal-perinatal medicine physician provider located in Edinburg, Texas. This profile covers 0 Medicare and 16 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	Neonatology Consultnants Of South Texas PLLC
Address	3111 Center Point Dr
City	Edinburg
State	TX
ZIP	78539
Taxonomy	Neonatal-Perinatal Medicine Physician
NPI Enumerated	September 21, 2007

Payer Source	Total Paid
Medicaid	$11.9M
Medicare	$0

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	8,960	$340	$3M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	21,720	$120	$2.6M
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	23,710	$60	$1.4M
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	16,050	$80	$1.2M
99468	The provider evaluates and manages the initial care of a newborn or infant less than 28 days of age in a neonatal critical care setting.	1,270	$800	$1M
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	7,250	$110	$827K
99464	The provider is present during the delivery, at the request of the delivering provider, and during the basic stabilization of the newborn immediately after birth, typically when fetal distress or…	6,910	$90	$594.1K
99477	The provider performs the initial day of inpatient hospital evaluation and management for a neonate, age 28 days or younger, who requires intensive care and observation as well as frequent…	1,400	$350	$494.9K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	3,030	$100	$306.1K
99462	The provider performs the evaluation and management of a normal newborn on a day subsequent to the initial hospital evaluation.	3,890	$40	$143.7K

Showing 1–10 of 16

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

Neonatology Consultnants Of South Texas PLLC — 6 of 16 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

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	7	30	1,410	$340	$2.5M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	5	30	3,360	$120	$1.2M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	19	30	1,140	$370	$1.2M
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	11	40	1,860	$110	$997.5K
99468	The provider evaluates and manages the initial care of a newborn or infant less than 28 days of age in a neonatal critical care setting.	2	30	100	$780	$242.1K
99464	The provider is present during the delivery, at the request of the delivering provider, and during the basic stabilization of the newborn immediately after birth, typically when fetal distress or…	4	30	910	$80	$190K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	7	220	130	$80	$180.8K
99477	The provider performs the initial day of inpatient hospital evaluation and management for a neonate, age 28 days or younger, who requires intensive care and observation as well as frequent…	1	20	80	$340	$89.1K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	681	960	310	$40	$88.6K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	7	530	120	$60	$86.8K

Showing 1–10 of 16

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mcallen Hospitals L P	TX	General Acute Care Hospital	$0	$124.6M
Doctors Hospital At Renaissance, Ltd	TX	General Acute Care Hospital	$0	$65.1M
Tropical Texas Behavioral Health	TX	Multi-Specialty Clinic/Center	$0	$61.5M
Nuestro Sagrado Corazon Primary Home Care, Inc.	TX	Personal Care Attendant	$0	$56.5M
Regional Nursing Services Mgmt., Inc.	TX	Home Health Agency	$0	$45.5M
Verge Primary Home Care	TX	Personal Care Attendant	$0	$42.7M
Arc Primary Care, LLC.	TX	Home Health Agency	$0	$42.3M
Heaven Sent Services, L.L.C.	TX	Personal Care Attendant	$0	$40.4M
Ddnj, Inc.	TX	In Home Supportive Care Agency	$0	$34.3M
Life Choices Unlimited, Inc.	TX	Child Intellectual and/or Developmental Disabilities Respite Care	$0	$28M

Neonatology Consultnants Of South Texas PLLC — Billing Profile & Reimbursement Data

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Neonatology Consultnants Of South Texas 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

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