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.

Utmb Faculty Group Practice (NPI 1942241146)

Key Findings

Field	Value
Entity Type	Organization
Organization	Utmb Faculty Group Practice
Address	301 University Blvd
City	Galveston
State	TX
ZIP	77555
Taxonomy	General Practice Physician
NPI Enumerated	June 9, 2006

Payer Source	Total Paid
Medicaid	$98.9M
Medicare	$0

UTMB FACULTY GROUP PRACTICE is effectively a single‑payer Medicaid biller: there is no Medicare revenue on file and the provider reports $98.9M in lifetime Medicaid revenue. This pattern makes Medicaid the sole material source of reported programmatic revenue for this NPI.

Revenue is highly concentrated in a small set of outpatient and preventive codes: the top three Medicaid codes (99213, 99214, 99391) account for 44.0% of the provider's total Medicaid revenue. Specifically, 99213 represents $18.3M (21.5% of Medicaid revenue), 99214 represents $12.4M (14.6%), and 99391 represents $6.7M (7.9%), indicating the bulk of dollars flow from office E/M and preventive visits.

The code mix signals a blended operation emphasizing high‑volume ambulatory E/M and pediatric preventive care alongside substantial obstetrics and newborn services. High counts and revenue for 99213 (469.6K claims, $39 avg paid/claim, $18.3M) and 99214 (229.7K claims, $54 avg paid/claim, $12.4M) point to heavy primary care/ambulatory throughput, while 59409 (9.5K claims, $660 avg paid/claim, $6.3M) and neonatal codes such as 99469 (15.4K claims, $404 avg paid/claim, $6.2M) show significant maternity/newborn activity.

Statewide competitive standing is dominant for many of the top codes: 99213 ranks #4 of 6037 providers in‑state and 99214 ranks #7 of 5814 providers (both 100th percentile; extreme outlier), while 99391 ranks #3 of 1362 providers (100th percentile; extreme outlier). Multiple other codes likewise sit at very high percentiles (for example, 99392, 90460, 99204, and 99393 all show 100th‑percentile or near‑top ranks), which characterizes the provider as a major statewide outlier in volume for core ambulatory and pediatric services.

Perinatal and neonatal service depth is evident from several high‑ranking codes: 59409 (9.5K claims, $660 avg paid/claim, $6.3M) ranks #2 of 271 providers in‑state (100th percentile; extreme outlier), 59514 (3.4K claims, $753 avg paid/claim, $2.6M) ranks #2 of 157 (99th percentile; extreme outlier), and 99468 (1.3K claims, $958 avg paid/claim, $1.2M) ranks #1 of 25 providers in‑state (100th percentile). These placements indicate substantial maternity and neonatal capacity relative to in‑state peers.

Preventive and pediatric care volumes are notably large: 99392 (83.2K claims, $81 avg paid/claim, $6.7M) and 99393 (23.7K claims, $93 avg paid/claim, $2.2M) both rank at or near the top of in‑state lists (100th and 99th percentiles respectively), and vaccine administration 90460 (299.3K claims, $11 avg paid/claim, $3.3M) is also an extreme outlier (rank #3 of 1647 providers, 100th percentile). Together these figures support that well‑child and immunization services are a major operational focus.

The provider also shows very high intake and inpatient E/M activity relative to peers: 99204 (24.3K claims, $86 avg paid/claim, $2.1M) ranks #1 of 1519 providers in‑state (100th percentile; extreme outlier), and inpatient discharge code 99238 (28.5K claims, $64 avg paid/claim, $1.8M) ranks #5 of 529 providers (99th percentile; extreme outlier). These patterns point to substantial new‑patient evaluation and hospital throughput in addition to routine follow‑ups.

The NPI has been enumerated since 2006‑06‑09 (~20 years ago), indicating an established billing history. Combined with the absence of Medicare volume, the long tenure plus concentrated Medicaid exposure suggests the provider has built a large, Medicaid‑centric patient base and may be particularly sensitive to Medicaid policy and rate changes.

Medicaid: Complete Services Breakdown

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

294 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…	469,570	$40	$18.3M
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…	229,690	$50	$12.4M
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…	83,230	$80	$6.7M
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	9,530	$660	$6.3M
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.	15,350	$400	$6.2M
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…	58,320	$90	$5M
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.	299,290	$10	$3.3M
59514	The provider admits the patient to the hospital for delivery, delivers the fetus and placenta via an abdominal incision, and provides care immediately after delivery on the same date of service. This…	3,410	$750	$2.6M
01967	The provider performs neuraxial anesthesia services for a patient undergoing a planned vaginal delivery.	7,440	$300	$2.2M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	23,720	$90	$2.2M

Showing 1–10 of 294

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

Utmb Faculty Group Practice — 18 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

294 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.	5	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.	9	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.	6	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.	10	40	1,860	$110	$997.5K
01967	The provider performs neuraxial anesthesia services for a patient undergoing a planned vaginal delivery.	11	80	1,160	$220	$768.8K
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.	13	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…	9	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,…	12	60	340	$590	$491.5K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	8	110	80	$1,260	$398.1K
00170	The provider performs anesthesia services for a patient undergoing an intraoral procedure, including biopsy.	43	100	410	$160	$390K

Showing 1–10 of 294

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ohiohealth Corporation	OH	Family Medicine Physician	$0	$89.1M
Imaging Subspecialists Of North Jersey, LLC	NJ	Diagnostic Radiology Physician	$0	$7.5M
Alyssa Rieber	TX	Hematology & Oncology Physician	$1.7M	$0
Shaheen Kavoussi	TX	Ophthalmology Physician	$1.6M	$0
Grant Fankhauser	AZ	Vascular Surgery Physician	$1.4M	$0
Larry Puthenparambil	TX	Retina Specialist (Ophthalmology) Physician	$1M	$0
Ahmad Rehmani	TX	Ophthalmology Physician	$1M	$0
Ammar Taha	WI	Diagnostic Radiology Physician	$410.5K	$380K
Nilofar Firooznia	CA	Diagnostic Radiology Physician	$516.5K	$76.7K
Vikram Shaker	NY	Diagnostic Radiology Physician	$543K	$220

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Of Texas Medical Branch At Galveston	TX	General Acute Care Hospital	$0	$150.3M
Qi Chen	TX	Diagnostic Radiology Physician	$253.3K	$78.2K
Jaafer Imam	TX	Critical Care Medicine (Internal Medicine) Physician	$301.1K	$0
Muhie Dean Sabayon	TX	Clinical Cardiac Electrophysiology Physician	$238K	$0
Cameron Ghaffary	TX	Surgery Physician	$235.9K	$0
Audrey Nath	TX	Neurological Surgery Physician	$210.5K	$0
Tomas Uribe Acosta	TX	Diagnostic Radiology Physician	$170.9K	$0
Murtaza Mazhar	TX	Cardiovascular Disease Physician	$150.5K	$0
Todd Swanson	TX	Radiation Oncology Physician	$137.7K	$0
Kishore Patcha	TX	Nephrology Physician	$120K	$0

Utmb Faculty Group Practice — 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