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.

Cook Children's Medical Center (NPI 1891765178)

Field	Value
Entity Type	Organization
Organization	Cook Children's Medical Center
Address	801 7th Ave
City	Fort Worth
State	TX
ZIP	76104
Taxonomy	Children's Hospital
NPI Enumerated	January 26, 2006

Payer Source	Total Paid
Medicaid	$286.6M
Medicare	$0

Key Findings

COOK CHILDREN'S MEDICAL CENTER reports $286.6M in lifetime Medicaid revenue and has no Medicare billing on file, making it effectively a single-payer Medicaid-focused provider in the available data. Its NPI was enumerated on 2006-01-26 (~20 years ago), indicating an established presence in the market.

Revenue is highly concentrated in emergency department E/M services: the top three Medicaid codes (99284, 99285, 99283) together account for 61.2% of the provider's total Medicaid revenue. Individually those codes generate $70.1M (99284, 25.6%), $51.2M (99285, 18.7%), and $46.5M (99283, 17.0%), signaling that a majority of dollars flow through higher-acuity ED encounters.

The code mix and volumes point to a large pediatric acute-care and emergency operations footprint: 99282 (84K claims, $30.8M), 99283 (72.9K claims, $46.5M), 99284 (42.6K claims, $70.1M) and 99285 (29.2K claims, $51.2M) together reflect heavy ED throughput across acuity levels, supported by observation (G0378) and very high-volume low-acuity outpatient encounters (99211: 181K claims, $8.3M). This pattern is consistent with a children’s hospital that combines high-volume front-door ED care with downstream observation and outpatient nursing visits.

State-level ranking shows dominant volume for several pediatric-utilization codes: 99282 ranks #1 of 368 providers in-state and is labeled an "extreme outlier" (100th percentile), 99281 ranks #1 of 149 (100th percentile, extreme outlier), and 99211 ranks #2 of 959 (100th percentile, extreme outlier). Other ED codes like 99283 and 99285 sit in the upper percentiles (98th and 96th, respectively), indicating the hospital is a major statewide participant for pediatric ED services, particularly on lower-acuity visit volumes.

Beyond ED care, the provider shows concentrated pediatric cardiology and imaging capacity: 93306 (6.9K claims, $15.1M, 5.5%) ranks #14 of 410 (97th percentile; notably above typical state volume), and 93000 (16.7K claims, $3.9M, 1.4%) ranks #6 of 516 (99th percentile; extreme outlier). These findings suggest significant on-site echocardiography and ECG services tied to the hospital’s pediatric specialty mix.

High-volume diagnostic and infectious-disease testing supports the clinical throughput profile: 87635 (50.3K claims, $2.9M, 1.1%) is an "extreme outlier" (100th percentile) and 87631 (24.4K claims, $4.1M, 1.5%) ranks #2 of 135 (99th percentile). Respiratory procedures such as 94640 (13K claims, $3.7M, 1.3%) rank #2 of 446 (100th percentile; extreme outlier), indicating substantial respiratory testing and treatment capacity that dovetails with the ED volume.

The provider combines very large claim counts for lower-paid services with concentrated high-revenue ED encounters: for example, 99211 generates 181K claims but only $8.3M (3.0%), while high-average-paid ED codes such as 99284 and 99285 drive the bulk of revenue. This mix implies operational scale driven by visit volume plus reliance on a smaller set of high-dollar ED codes for revenue, which could make payer-rate changes to ED E/M reimbursement material to financial performance.

Operationally and competitively, the hospital is an established pediatric hub in Fort Worth: long-tenured (NPI 2006-01-26, ~20 years) and repeatedly classified as an "extreme outlier" or "notably above typical" statewide for multiple codes (e.g., 99282, 99281, 99211, 71046, 94640, 87635). Its dominant statewide rankings for specific high-volume pediatric services position it as a key Medicaid service center in Texas, but its heavy dependence on a few ED codes (top three = 61.2% of Medicaid revenue) concentrates revenue risk around those service lines.

Medicaid: Complete Services Breakdown

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

238 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	42,590	$1,650	$70.1M
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.	29,230	$1,750	$51.2M
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.	72,900	$640	$46.5M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	83,960	$370	$30.8M
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…	6,890	$2,200	$15.1M
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.	181,010	$50	$8.3M
99281	The provider sees a patient for the lowest level emergency department visit.	29,610	$200	$5.9M
G0378	Hospital observation service, per hour	2,760	$1,670	$4.6M
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	5,570	$800	$4.5M
87631	The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,…	24,380	$170	$4.1M

Showing 1–10 of 238

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

Cook Children's Medical Center — 13 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

238 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	39	710	1,790	$200	$2.1M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	47	70	370	$760	$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.	18	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.	25	590	740	$170	$969.2K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	1,335	1,350	1,860	$80	$872.4K
95716	The patient undergoes electroencephalography, a study of the electrical activity of the brain, with continuous, real–time monitoring and maintenance. A video recording is made, and an EEG…	6	10	150	$1,580	$641.4K
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…	14	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,…	32	60	340	$590	$491.5K
G0378	Hospital observation service, per hour	6	70	300	$500	$465K
J0585	Injection, onabotulinumtoxina, 1 unit	1	20	200	$1,140	$437.7K

Showing 1–10 of 238

Related Providers

Other providers that share a Tax Identification Number (TIN) with Cook Children's Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cook Children's Physician Network	TX	Pediatrics Physician	$0	$106.2M
Cook Children's Physician Network	TX	Pediatric Emergency Medicine (Emergency Medicine) Physician	$0	$25.7M
Cook Children's Medical Center	TX	Pediatrics Physician	$0	$21.3M
Andrea Armstrong	TX	Family Nurse Practitioner	$22K	$0

Nearby Providers

Other providers in the same ZIP code as Cook Children's Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cook Childrens Home Health	TX	Durable Medical Equipment & Medical Supplies	$0	$64.4M
Tarrant County Hospital District	TX	General Acute Care Hospital	$0	$61.8M
Acclaim Physician Group, Inc	TX	Internal Medicine Physician	$0	$30.9M
Texas Health Harris Methodist Hospital Fort Worth	TX	General Acute Care Hospital	$0	$13.8M
James Haden	TX	Allergy & Immunology (Internal Medicine) Physician	$819.3K	$2.5M
Physicians Surgical Center Of Ft. Worth LLP	TX	Ambulatory Surgical Clinic/Center	$2.9M	$0
Sleep Telemedicine Services, Inc	TX	Sleep Disorder Diagnostic Clinic/Center	$187.3K	$2M
Matthew Cavey	TX	Radiation Oncology Physician	$1.9M	$0
Surgical Caregivers Of Fort Worth LLC	TX	Ambulatory Surgical Clinic/Center	$1.2M	$1.3K
Harshal Broker	TX	Vascular Surgery Physician	$1.2M	$0

Cook Children's Medical Center — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References