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.

Texas Children's Urgent Care (NPI 1871998963)

Texas Children's Urgent Care is a pediatrics physician provider located in Houston, Texas. This profile covers 0 Medicare and 44 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	Texas Children's Urgent Care
Address	1919 S Braeswood Blvd
City	Houston
State	TX
ZIP	77030
Taxonomy	Pediatrics Physician
NPI Enumerated	October 31, 2014

Payer Source	Total Paid
Medicaid	$63.7M
Medicare	$0

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

44 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…	287,670	$140	$38.8M
99203	The provider sees a new 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 provider…	129,370	$130	$16.9M
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…	38,150	$130	$5.1M
99204	The provider sees a new 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 provider…	16,810	$130	$2.2M
S9083	Global fee urgent care centers	2,080	$130	$260K
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,…	89,130	$1	$178.3K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	2,560	$40	$104.8K
T1015	Clinic visit/encounter, all-inclusive	400	$150	$61K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	500	$10	$2.5K
31720	In this procedure, the provider removes excess secretions, or aspirates, from the patient’s nasopharynx and trachea with the help of a suctioning catheter.	2,200	$1	$2.2K

Showing 1–10 of 44

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

Texas Children's Urgent Care — 6 of 17 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

44 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	596	770	2,990	$170	$2.6M
S9083	Global fee urgent care centers	8	30	210	$100	$822K
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…	10	6,040	710	$40	$232.8K
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…	56	5,810	540	$50	$155.5K
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,…	6	1,350	320	$30	$101.2K
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…	890	1,010	140	$70	$77.3K
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,…	1,864	1,920	220	$30	$65.9K
99203	The provider sees a new 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 provider…	1	1,860	130	$70	$65.4K
99051	The provider sees a patient during regular office hours that occur outside of traditional office hours, i.e., in the evening, on a weekend, or on a holiday.	2	320	220	$30	$59.4K
A4627	Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler	12	50	170	$20	$51.1K

Showing 1–10 of 44

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Texas Children's Hospital	TX	Children's Hospital	$0	$277.4M
Texas Children's Physician Group	TX	Pediatrics Physician	$0	$160.6M
Ut Physicians	TX	Anesthesiology Physician	$0	$94.4M
Memorial Hermann Health System	TX	General Acute Care Hospital	$0	$39.5M
Harris County Hospital District	TX	General Acute Care Hospital	$0	$27.7M
Baylor College Of Medicine	TX	Family Medicine Physician	$0	$18.1M
Igor Cherches	TX	Neurology Physician	$6.7M	$0
David Brown	TX	Ophthalmology Physician	$5.7M	$0
Tien Wong	TX	Ophthalmology Physician	$4.5M	$0
Ankoor Shah	TX	Ophthalmology Physician	$3.7M	$0

Texas Children's Urgent Care — Billing Profile & Reimbursement Data

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Texas Children's Urgent Care — 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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