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.

Bexar County Hospital District (NPI 1821011248)

Key Findings

Field	Value
Entity Type	Organization
Organization	Bexar County Hospital District
Address	4502 Medical Dr
City	San Antonio
State	TX
ZIP	78229
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 26, 2006

Payer Source	Total Paid
Medicaid	$91.4M
Medicare	$0

BEXAR COUNTY HOSPITAL DISTRICT appears effectively single‑payer in our dataset: there is no Medicare billing on file while total Medicaid revenue is $91.4M, so all recorded Medicare/Medicaid activity for this provider is driven by Medicaid claims. This concentrated payer footprint should be considered when comparing its volumes and revenue to typical hospitals that bill both programs.

Revenue concentration is high within a small set of outpatient and emergency E/M codes: the precomputed top 3 Medicaid codes account for 46.4% of total Medicaid revenue, with 99214 ($16.1M, 21.2%), 99284 ($11.7M, 15.4%), and 99285 ($7.5M, 9.9%) listed as the top three contributors. This pattern indicates that nearly half of the provider’s Medicaid dollars flow from a concentrated mix of mid‑ to high‑acuity evaluation and management services.

The CPT/HCPCS mix points to a dual focus on emergency department care and high-volume outpatient clinic visits: 99284 and 99285 are prominent ED E/M codes and 99214, 99213, and 99215 show exceptionally large claim counts (e.g., 99214: 293.6K claims; 99215: 115.7K claims; 99213: 139.8K claims). Together these counts and dollar amounts are consistent with a general acute care hospital operating both a busy ED and extensive outpatient clinics or hospital‑based ambulatory services.

Statewide competitive standing is strong for multiple high-volume codes: 99214 ranks #3 of 5814 providers in-state (100th percentile; extreme outlier) and 99215 ranks #1 of 1011 providers in-state (100th percentile; extreme outlier), while vaccination codes 90471 and 90472 also rank at the top of their peer lists (90471 #2 of 1407, 90472 #1 of 647, both 100th percentile; extreme outlier). These rank/percentile positions indicate the provider is a dominant participant in Texas for several outpatient visit and immunization services.

The provider also shows substantial diagnostic and infectious‑disease testing throughput: U0004 has 26.6K claims and $2.3M revenue (ranks #6 of 104 in-state, 95th percentile) and C9803 has 42.8K claims and $984.5K revenue (ranks #2 of 142, 99th percentile; extreme outlier). High volumes across 87633, 87637, 87636, and U0005 reinforce that hospital outpatient testing for respiratory pathogens and SARS‑CoV‑2 specimen collection are meaningful service lines for Medicaid revenue.

Obstetric and prenatal imaging is a measurable service area: multiple ultrasound and fetal monitoring codes appear on the top list (76816 $1.8M, 76805 $665.9K, 76830 $634.6K with 76830 ranking #4 of 253 in-state, 99th percentile; extreme outlier), indicating a sizeable maternal/fetal imaging program contributing to Medicaid revenue. These items suggest the hospital supports significant prenatal care volume in addition to ED and outpatient visits.

Revenue-per‑claim varies sharply by service line, highlighting different business economics: high‑acuity ED and procedure codes show large avg paid/claim values (99284 $761 avg paid/claim; 99285 $849 avg paid/claim; 69210 $653 avg paid/claim) while mass outpatient services like vaccine administration have very low avg paid/claim (90471 $15 avg paid/claim; 90472 $13 avg paid/claim) but extremely high claim counts (90471 135.3K claims; 90472 133K claims). This mix means a sizable portion of revenue is driven by fewer, high‑dollar ED events alongside very high‑volume, low‑margin preventive care and testing services.

The provider has a long tenure in the registry (NPI enumerated 2006-07-26 (~20 years ago)), which, combined with its dominant statewide rankings on several codes, indicates an established presence and sustained Medicaid‑focused operations in San Antonio. Given the absence of Medicare billing on file, network analyses and contracting strategies should treat this entity primarily as a Medicaid revenue center in this dataset.

Medicaid: Complete Services Breakdown

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

406 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…	293,570	$60	$16.1M
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.	15,370	$760	$11.7M
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.	8,880	$850	$7.5M
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…	139,830	$50	$7.3M
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	14,330	$500	$7.1M
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…	115,680	$60	$6.4M
U0004	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…	26,560	$90	$2.3M
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	135,300	$20	$2M
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	42,210	$50	$1.9M
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	13,270	$140	$1.8M

Showing 1–10 of 406

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

Bexar County Hospital District — 14 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

406 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;…	19	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.	120	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.	149	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.	87	590	740	$170	$969.2K
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.	25	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…	70	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,…	20	60	340	$590	$491.5K
G0378	Hospital observation service, per hour	25	70	300	$500	$465K
J0585	Injection, onabotulinumtoxina, 1 unit	4	20	200	$1,140	$437.7K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	5	120	340	$120	$422K

Showing 1–10 of 406

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
A Plus Family Care LLC	TX	Home Health Agency	$0	$72.7M
Methodist Healthcare System Of San Antonio, Ltd., L.L.P.	TX	General Acute Care Hospital	$0	$68M
Casa Linda Homecare, Inc.	TX	Home Health Agency	$0	$39.7M
Axiom Home Health LLC	TX	Home Health Agency	$0	$39.2M
University Of Texas Health Science Center At San Antonio	TX	Internal Medicine Physician	$0	$35.5M
Easter Seal Rehabilitation Center	TX	Registered Dietitian	$0	$24.2M
Access Quality Therapy Services, LLC	TX	Home Health Agency	$0	$23.4M
Emergency Medicine Services Of Tx, PLLC	TX	Emergency Medicine Physician	$0	$15M
San Rafael Healthcare, Inc	TX	Home Health Agency	$0	$13.6M
Pathology Reference Laboratory, L.L.C.	TX	Clinical Medical Laboratory	$1.2M	$4.7M

Bexar County Hospital District — Billing Profile & Reimbursement Data

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Bexar County Hospital District — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References