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.

Children's Physician Services Of South Texas (NPI 1801856786)

Children's Physician Services Of South Texas is a pediatrics physician provider located in Corpus Christi, Texas. This profile covers 0 Medicare and 233 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	Children's Physician Services Of South Texas
Address	3533 S Alameda St
City	Corpus Christi
State	TX
ZIP	78411
Taxonomy	Pediatrics Physician
NPI Enumerated	March 24, 2006

Payer Source	Total Paid
Medicaid	$50.9M
Medicare	$0

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

233 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	118,000	$70	$7.8M
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…	146,270	$50	$7.2M
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…	30,970	$130	$4M
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	49,900	$60	$3.1M
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	33,060	$80	$2.7M
99215	The provider sees an established 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…	22,030	$100	$2.3M
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	16,970	$120	$2M
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	20,840	$90	$1.9M
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…	12,650	$120	$1.5M
76815	The provider performs a limited examination of the fetus using ultrasound. The provider performs the examination of certain parameters for one or more fetuses.	25,270	$60	$1.4M

Showing 1–10 of 233

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

Children's Physician Services Of South Texas — 20 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

233 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.	22	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.	22	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.	14	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.	29	40	1,860	$110	$997.5K
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	18	30	330	$1,020	$750.2K
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	11	70	850	$180	$621.2K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	19	60	340	$590	$491.5K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	4	110	80	$1,260	$398.1K
00170	The provider performs anesthesia services for a patient undergoing an intraoral procedure, including biopsy.	21	100	410	$160	$390K
01922	The provider performs anesthesia services for a patient undergoing non–invasive imaging or radiation therapy.	16	20	340	$210	$299.2K

Showing 1–10 of 233

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Michael Decandia	TX	Diagnostic Radiology Physician	$124.9K	$0
Alma Rigonan	TX	Pediatrics Physician	$117.7K	$0
Stephanie Kingman	TX	Family Nurse Practitioner	$93.4K	$0
Sheetal Malik	KS	Neurology Physician	$52.5K	$0
Mario Moya	PA	Vascular & Interventional Radiology Physician	$39.1K	$0
Janel Schneider	WI	Neurology Physician	$13K	$0
Cristina Rhodes	MO	Certified Registered Nurse Anesthetist	$3.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Driscoll Childrens Hospital	TX	Children's Hospital	$0	$133.2M
Hub City Home Health Inc	TX	Home Health Agency	$0	$43.8M
Epic Health Services, Inc.	TX	Home Health Agency	$0	$30M
Driscoll Children's Hospital	TX	Ambulance	$0	$25.6M
Coastal Children's Clinic PA	TX	Pediatrics Physician	$0	$14.5M
Educare Community Living Corporation - Texas	TX	Community/Behavioral Health Agency	$0	$12.7M
Sacred Heart Home Health Inc.	TX	Personal Care Attendant	$0	$11.1M
X-ray On Wheels, Inc.	TX	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	$4.6M	$3.9M
Tac Med Inc.	TX	Land Ambulance	$1.6M	$2.4M
Wayne Fagan	TX	MOHS-Micrographic Surgery Physician	$708.5K	$0

Children's Physician Services Of South Texas — Billing Profile & Reimbursement Data

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Children's Physician Services Of South Texas — 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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