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.

All Children's Pediatric Clinic P.A. (NPI 1730257106)

All Children's Pediatric Clinic P.A. is a pediatrics physician provider located in Mcallen, Texas. This profile covers 0 Medicare and 91 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	All Children's Pediatric Clinic P.A.
Address	6900 N 10th St Ste 8
City	Mcallen
State	TX
ZIP	78504
Taxonomy	Pediatrics Physician
NPI Enumerated	December 1, 2006

Payer Source	Total Paid
Medicaid	$16M
Medicare	$0

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

91 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…	154,000	$30	$5.2M
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	48,820	$40	$2.1M
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.	65,100	$10	$846.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	11,760	$70	$835K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	11,350	$70	$828.5K
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…	10,770	$70	$742.9K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	57,110	$10	$742.4K
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…	15,190	$50	$729K
S8301	Infection control supplies, not otherwise specified	81,610	$10	$571.3K
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…	7,140	$70	$492.5K

Showing 1–10 of 91

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

All Children's Pediatric Clinic P.A. — 16 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

91 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	53	240	420	$30	$296.8K
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…	27	6,040	710	$40	$232.8K
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…	43	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…	89	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…	232	5,810	540	$50	$155.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	25	1,540	650	$80	$150.4K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	342	350	230	$70	$120.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	16	1,540	360	$80	$110.6K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	12	1,350	320	$30	$101.2K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	51	1,650	2,350	$10	$88.7K

Showing 1–10 of 91

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Alegria Primary Home Care, Inc.	TX	Personal Care Attendant	$0	$96.8M
Rio Grande Valley Phc/cba, LLC	TX	Personal Care Attendant	$0	$64.8M
Apex Primary Care Inc	TX	Home Health Agency	$0	$61.2M
Sarojini Bose Md PA	TX	Pediatrics Physician	$0	$39.4M
Pediatric Services Of America, LLC	TX	Nursing Care Agency	$0	$31.3M
Estrella Phc Services	TX	In Home Supportive Care Agency	$0	$24M
Prosperity Health Care, LLC	TX	Home Health Agency	$0	$18M
4 Genesis Primary Home Care, LLC	TX	Personal Care Attendant	$0	$16.5M
Abundant Health Care Inc	TX	Home Health Agency	$0	$16M
Wings Home Health Services, LLC	TX	Home Health Agency	$0	$15.6M

All Children's Pediatric Clinic P.A. — Billing Profile & Reimbursement Data

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All Children's Pediatric Clinic P.A. — 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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Frequently Asked Questions

References