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.

Austin Regional Clinic, PA (NPI 1821157579)

Austin Regional Clinic, PA is a family medicine physician provider located in Austin, Texas. This profile covers 0 Medicare and 104 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	Austin Regional Clinic, PA
Address	6210 E Us Hwy 290
City	Austin
State	TX
ZIP	78723
Taxonomy	Family Medicine Physician
NPI Enumerated	December 8, 2006

Payer Source	Total Paid
Medicaid	$14.7M
Medicare	$0

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

104 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…	141,470	$40	$5.2M
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.	120,520	$10	$1.3M
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…	15,050	$80	$1.2M
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…	14,000	$80	$1.1M
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…	14,400	$80	$1.1M
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…	18,710	$50	$935.7K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	7,870	$120	$921.3K
99050	In this procedure, the provider renders services to a patient in his office at a time when that office would otherwise be closed.	29,000	$30	$782.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5,510	$90	$479.6K
U0005	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, cdc or non-cdc,…	11,610	$30	$290.2K

Showing 1–10 of 104

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

Austin Regional Clinic, PA — 10 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

104 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	22	340	400	$50	$553.5K
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)…	48	120	340	$120	$422K
81513	The lab analyst performs the technical lab test on a vaginal fluid specimen for quantitative real–time amplification of RNA markers for three bacterial species listed in the code descriptor, and…	24	30	410	$70	$363.5K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	5	160	200	$110	$323.8K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	98	120	310	$220	$302.6K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	174	370	550	$80	$249.6K
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…	32	6,040	710	$40	$232.8K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	152	290	410	$20	$225K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	155	300	410	$20	$223.4K
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…	190	210	260	$120	$221.2K

Showing 1–10 of 104

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Darush Rahmani	TX	Rheumatology Physician	$1.4M	$0
Anurekha Chadha	TX	Rheumatology Physician	$863.1K	$0
Pedro Vargas	NC	Diagnostic Radiology Physician	$439.5K	$0
Vineet Seth	TX	Diagnostic Radiology Physician	$416.8K	$0
Bradley Unruh	NC	Diagnostic Radiology Physician	$279.6K	$0
Yun Xie	TX	Diagnostic Radiology Physician	$259.2K	$0
David Mitchell	TX	Diagnostic Radiology Physician	$205.8K	$0
Marc-fernand Erian	CA	Diagnostic Radiology Physician	$157.9K	$0
Robert Chandler	TX	Diagnostic Radiology Physician	$151.7K	$0
Ripa Chakravorty	TX	Cardiovascular Disease Physician	$135.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ascension Seton	TX	Children's Hospital	$0	$29.4M
Central Texas Community Health Centers	TX	Federally Qualified Health Center (FQHC)	$0	$28.7M
Dell Children's Medical Group	TX	Pediatrics Physician	$0	$11.1M
Brian Leykum	TX	Podiatrist	$196.9K	$0
Jose Grijalva	TX	Psychiatry Physician	$118.3K	$0
Malcolm Duncan	TX	Psychiatric/Mental Health Nurse Practitioner	$106.7K	$0

Austin Regional Clinic, PA — Billing Profile & Reimbursement Data

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Austin Regional Clinic, PA — 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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