Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Physician

Texas Children's Physician Group

Texas Children's Physician Group was paid $160.81M by Medicaid between Jan 2018 and Dec 2024, across 343 billing codes. Its largest line is 99284, emergency room visit (serious) — 12% of everything it billed.

33Billing provider infoTEXAS CHILDREN'S PHYSICIAN GROUP
HOUSTON, TX 77030
33aNPI1861675506assigned 12/17/2007
33bProvider typePediatrics Physician
28Total paid$160.81M
24GClaims2,513,595
24DCodes billed343
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Pediatrics Physician providers in Texas

Rank by total paid#2 of 1,136
Median peer was paid$329K
This provider vs. median490×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

$0$2.0M$4.0M2018201920202021202220232024
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
YearClaimsPaid
20185,147$59K
20196,874$164K
2020121,336$7.23M
2021576,774$37.01M
2022625,852$41.25M
2023628,506$39.46M
2024incomplete549,106$35.64M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99284 Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity 12% 181,840 178,720 $19.88M
99214 Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 9.8% 261,866 254,592 $15.69M
99244 Office or other outpatient consultation, moderate to high complexity 6.3% 62,608 61,449 $10.08M
99215 Doctor's office visit, returning patient (complex)Prolong outpt/office vis 5.9% 106,066 98,352 $9.49M
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 5.4% 207,364 189,118 $8.68M
99243 3.8% 52,431 51,677 $6.03M
99472 Subsequent inpatient pediatric critical care, per day, 2-5 years 3.7% 14,136 3,891 $5.96M
99233 Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m 3.6% 71,683 32,256 $5.76M
00170 Anesthesia for intraoral procedures, including biopsy 3.3% 20,002 19,653 $5.27M
99283 Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity 2.6% 68,458 67,700 $4.26M
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes 2.6% 17,980 7,445 $4.15M
99285 Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life 2.4% 28,239 27,801 $3.85M
331 more codes
99203 Doctor's office visit, new patient (routine) 2.1% 52,738 $3.45M
99232 Hospital visit by a doctor, follow-up day 1.6% 44,806 $2.65M
99238 Hospital discharge day management, 30 minutes or less 1.6% 34,305 $2.51M
99469 Subsequent inpatient neonatal critical care, per day, 28 days or younger 1.5% 5,346 $2.40M
99480 Subsequent intensive care, per day, low birth weight infant 1.4% 15,038 $2.20M
99460 1.4% 22,206 $2.20M
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia 1.3% 16,460 $2.08M
99204 Doctor's office visit, new patient (more involved) 1.2% 20,575 $1.96M
93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study 1.1% 21,340 $1.76M
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 1.1% 16,475 $1.75M
95720 <1% 8,569 $1.59M
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient <1% 18,616 $1.59M
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up <1% 30,708 $1.46M
76705 Ultrasound, abdominal, real time with image documentation; limited <1% 44,419 $1.31M
42820 Tonsillectomy and adenoidectomy; younger than age 12 <1% 4,175 $1.26M
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences <1% 11,103 $1.21M
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only <1% 101,625 $1.17M
71045 Radiologic examination, chest; single view <1% 141,265 $1.10M
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed <1% 12,162 $1.03M
76770 <1% 24,894 $975K
95810 Polysomnography; sleep staging with 4 or more additional parameters <1% 8,534 $944K
01922 <1% 2,240 $883K
70450 Computed tomography, head or brain; without contrast material <1% 20,832 $833K
70551 Magnetic resonance imaging, brain; without contrast material <1% 11,142 $794K
92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient <1% 13,376 $786K
59025 Fetal non-stress test <1% 28,899 $766K
99205 Prolong outpt/office vis <1% 5,808 $761K
71046 Radiologic examination, chest; 2 views <1% 63,690 $706K
92060 <1% 10,588 $642K
99245 <1% 2,728 $629K
90791 Psychiatric diagnostic evaluation <1% 4,042 $605K
93320 <1% 22,820 $543K
99479 Subsequent intensive care, per day, very low birth weight infant <1% 3,361 $522K
99239 Hospital discharge day management, more than 30 minutes <1% 5,461 $521K
99223 Prolong inpt eval add15 m <1% 3,152 $512K
99254 <1% 3,057 $483K
96112 <1% 3,908 $481K
99462 <1% 9,982 $468K
92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient <1% 4,556 $452K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward <1% 15,789 $435K
74018 <1% 48,199 $431K
95812 <1% 6,580 $430K
99253 <1% 4,027 $401K
74177 Computed tomography, abdomen and pelvis; with contrast material <1% 4,475 $383K
93975 <1% 6,714 $383K
90847 Family psychotherapy with the patient present, 50 minutes <1% 3,545 $363K
99222 Initial hospital care, per day, moderate complexity <1% 2,764 $343K
93227 <1% 10,481 $333K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material <1% 4,626 $318K
95782 <1% 2,645 $306K
90837 Psychotherapy session, about an hour <1% 2,588 $294K
99255 <1% 1,465 $286K
44970 <1% 527 $278K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited <1% 8,968 $264K
99417 Prolong home eval add 15m <1% 7,826 $241K
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete <1% 5,979 $232K
95718 <1% 1,934 $227K
93325 <1% 51,280 $217K
54150 <1% 2,271 $217K
72082 <1% 12,394 $212K
76506 <1% 7,044 $180K
99231 Subsequent hospital care, per day, straightforward or low complexity <1% 4,806 $180K
49452 <1% 1,298 $174K
90834 Psychotherapy session, about 45 minutes <1% 2,006 $170K
00126 <1% 956 $160K
92015 Determination of refractive state <1% 32,016 $144K
90792 Psychiatric diagnostic evaluation with medical services <1% 867 $141K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation <1% 2,605 $134K
72170 <1% 12,923 $133K
93321 <1% 14,050 $131K
99242 <1% 1,450 $130K
74019 <1% 11,541 $129K
76801 <1% 1,459 $128K
D0120 Dental checkup, returning patient <1% 6,824 $128K
76536 <1% 4,146 $126K
69210 <1% 4,101 $125K
76700 Ultrasound, abdominal, real time with image documentation; complete <1% 2,717 $121K
93308 <1% 3,626 $118K
D1120 Dental cleaning, child <1% 5,647 $115K
95251 <1% 4,589 $109K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal <1% 1,397 $108K
76820 <1% 4,686 $103K
93304 <1% 2,243 $98K
42830 <1% 459 $93K
D8670 Periodic orthodontic treatment visit <1% 2,633 $87K
92201 <1% 4,559 $87K
54161 <1% 364 $86K
74230 <1% 3,263 $85K
73090 <1% 9,655 $81K
96409 <1% 889 $79K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward <1% 1,669 $76K
73630 <1% 8,117 $74K
75573 <1% 619 $70K
D1206 Topical application of fluoride varnish <1% 7,600 $69K
94010 <1% 7,914 $68K
73610 <1% 6,889 $68K
95783 <1% 547 $67K
99157 <1% 281 $66K
85025 Blood count; complete (CBC), automated, and automated differential WBC count <1% 9,771 $64K
90832 Psychotherapy session, about 30 minutes <1% 858 $64K
77072 <1% 6,119 $62K
D1110 Prophylaxis - adult <1% 1,727 $62K
96450 <1% 791 $60K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 5,911 $58K
92133 <1% 1,774 $58K
76819 Fetal biophysical profile; without non-stress testing <1% 1,495 $56K
99464 <1% 456 $52K
77073 <1% 3,285 $49K
73100 <1% 4,967 $48K
76882 <1% 1,919 $46K
73080 <1% 5,053 $46K
73590 <1% 5,116 $45K
59409 Vaginal delivery only (with or without episiotomy and/or forceps) <1% 52 $41K
99282 Emergency department visit for the evaluation and management, low to moderate severity <1% 1,096 $40K
92227 <1% 3,168 $40K
17110 <1% 501 $40K
99217 <1% 561 $38K
76818 <1% 443 $38K
99241 <1% 733 $38K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) <1% 308 $38K
94060 <1% 3,372 $38K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) <1% 334 $36K
85045 <1% 10,928 $36K
76830 Ultrasound, transvaginal <1% 828 $34K
62370 <1% 674 $34K
99471 <1% 37 $34K
76885 <1% 807 $33K
77075 <1% 1,145 $31K
54640 <1% 49 $31K
59430 <1% 245 $30K
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple <1% 218 $28K
97597 <1% 802 $28K
71260 Computed tomography, thorax, diagnostic; with contrast material <1% 383 $28K
64642 <1% 268 $27K
64643 <1% 287 $27K
73140 <1% 3,610 $27K
73130 <1% 2,836 $27K
70543 <1% 243 $26K
99220 <1% 166 $25K
11772 <1% 44 $25K
D0210 Intraoral - complete series of radiographic images <1% 616 $24K
99476 <1% 77 $24K
43762 <1% 300 $24K
92250 <1% 826 $23K
72148 Magnetic resonance imaging, lumbar spine; without contrast material <1% 343 $23K
D0150 Comprehensive oral evaluation - new or established patient <1% 1,204 $23K
D1351 Sealant - per tooth <1% 1,409 $22K
D7140 Extraction, erupted tooth or exposed root <1% 901 $22K
92083 <1% 656 $22K
99155 <1% 272 $21K
73562 <1% 1,815 $19K
95819 <1% 302 $19K
73110 <1% 1,942 $19K
51600 <1% 386 $19K
70360 <1% 1,965 $18K
D9420 <1% 1,211 $18K
93272 <1% 438 $17K
D2930 Prefabricated stainless steel crown - primary tooth <1% 276 $17K
74240 <1% 429 $17K
92002 <1% 265 $17K
73560 <1% 1,856 $16K
90846 Family psychotherapy without the patient present, 50 minutes <1% 194 $16K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) <1% 161 $16K
90472 Immunization administration, each additional vaccine (list separately) <1% 1,992 $15K
92504 <1% 1,763 $15K
73552 <1% 1,515 $15K
81003 <1% 5,776 $15K
95811 <1% 124 $15K
95004 Percutaneous tests with allergenic extracts, immediate type reaction <1% 135 $14K
29888 <1% 12 $14K
51728 <1% 91 $14K
01920 <1% 40 $13K
96132 <1% 130 $13K
99292 <1% 114 $13K
99252 <1% 172 $13K
00920 <1% 62 $13K
96113 <1% 146 $12K
71250 <1% 210 $12K
96156 <1% 155 $12K
99418 Prolong nursin fac eval 15m <1% 233 $12K
76870 <1% 312 $11K
78264 <1% 290 $11K
90715 <1% 277 $11K
D0272 Bitewings - two radiographic images <1% 1,161 $11K
81025 <1% 1,372 $11K
78816 <1% 93 $10K
72081 <1% 751 $10K
93790 <1% 582 $10K
31615 <1% 96 $10K
54360 <1% 12 $10K
72100 <1% 785 $10K
73070 <1% 1,048 $9K
74455 <1% 582 $9K
99219 <1% 95 $9K
94621 <1% 108 $8K
99140 <1% 100 $8K
90853 Group psychotherapy (other than of a multiple-family group) <1% 293 $8K
95873 <1% 396 $8K
76821 <1% 277 $7K
29450 <1% 98 $7K
D0140 Limited oral evaluation - problem focused <1% 709 $7K
36557 <1% 26 $7K
96131 <1% 57 $7K
31526 <1% 79 $7K
51798 <1% 763 $7K
00300 <1% 26 $7K
31622 <1% 84 $7K
72040 <1% 559 $7K
72141 <1% 87 $7K
D0330 Panoramic radiographic image <1% 332 $6K
96130 <1% 57 $6K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years <1% 65 $6K
96133 <1% 29 $6K
73723 <1% 58 $6K
73221 <1% 84 $6K
76942 <1% 181 $6K
73000 <1% 573 $5K
99358 Prolong nursin fac eval 15m <1% 52 $5K
77002 <1% 193 $5K
51741 <1% 576 $5K
76825 <1% 58 $5K
76937 <1% 383 $5K
93976 <1% 132 $5K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type <1% 318 $5K
D7240 Removal of impacted tooth - completely bony <1% 76 $5K
93294 <1% 176 $5K
93042 <1% 508 $5K
99221 <1% 66 $5K
85027 <1% 809 $5K
77001 <1% 268 $5K
99236 Prolong inpt eval add15 m <1% 35 $5K
90686 <1% 1,681 $5K
75574 <1% 39 $5K
72158 <1% 38 $5K
93971 <1% 265 $4K
73030 <1% 434 $4K
96137 <1% 109 $4K
73060 <1% 431 $4K
70250 <1% 390 $4K
D0367 <1% 124 $4K
92228 <1% 322 $4K
51797 <1% 79 $4K
00731 <1% 12 $4K
99100 <1% 38 $4K
29065 <1% 39 $3K
70486 <1% 80 $3K
73564 <1% 284 $3K
90480 <1% 104 $3K
70491 <1% 41 $3K
76981 <1% 92 $3K
85007 <1% 809 $3K
73660 <1% 325 $3K
95816 <1% 40 $3K
74183 <1% 25 $2K
73620 <1% 310 $2K
93000 <1% 204 $2K
96158 <1% 56 $2K
31575 <1% 43 $2K
99201 <1% 57 $2K
96110 Developmental screening, with scoring and documentation, per standardized instrument <1% 223 $2K
76827 <1% 83 $2K
91122 <1% 28 $2K
J9370 Vincristine sulfate, 1 mg <1% 261 $2K
93886 <1% 46 $2K
77080 <1% 214 $2K
76642 <1% 55 $2K
73718 <1% 31 $2K
51784 <1% 58 $2K
74181 <1% 26 $2K
72070 <1% 156 $2K
96136 <1% 69 $2K
99235 <1% 14 $2K
72157 <1% 12 $2K
72156 <1% 13 $2K
99354 <1% 26 $2K
73720 <1% 17 $2K
94016 <1% 59 $2K
75565 <1% 127 $2K
31579 <1% 12 $1K
92226 <1% 110 $1K
92285 <1% 150 $1K
99356 <1% 21 $1K
96411 <1% 21 $1K
38222 <1% 13 $1K
91120 <1% 12 $1K
78803 <1% 14 $844.35
76813 <1% 13 $830.45
71555 <1% 12 $821.45
D1208 Topical application of fluoride, excluding varnish <1% 173 $820.26
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) <1% 13 $795.93
99375 <1% 14 $731.60
92134 <1% 26 $709.38
72125 Computed tomography, cervical spine; without contrast material <1% 13 $692.11
93018 <1% 28 $677.33
93356 <1% 1,866 $674.92
S0620 Routine ophthalmological examination including refraction; new patient <1% 298 $633.31
92025 <1% 40 $597.25
69200 <1% 12 $530.30
74270 <1% 13 $505.17
83036 Hemoglobin; glycosylated (A1C) <1% 102 $498.30
D0220 Intraoral - periapical first radiographic image <1% 257 $464.72
90656 <1% 275 $377.16
94729 <1% 40 $361.56
93295 <1% 12 $350.57
74340 <1% 12 $317.68
D0145 Oral evaluation for a patient under three years of age <1% 149 $312.00
97602 <1% 182 $280.00
D0230 Intraoral - periapical each additional radiographic image <1% 211 $230.20
62368 <1% 12 $229.99
44500 <1% 12 $221.49
95885 <1% 13 $191.02
D0470 <1% 13 $176.40
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis <1% 66 $162.66
73600 <1% 16 $118.93
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity <1% 18 $116.63
94150 <1% 14 $8.44
90785 <1% 344 $2.34
90688 <1% 106 $0.76
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) <1% 887 $0.10
90651 <1% 80 $0.03
90670 0% 13 $0.00
90633 0% 13 $0.00
S0621 Routine ophthalmological examination including refraction; established patient 0% 89 $0.00
99448 0% 78 $0.00
G2212 Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes) 0% 16 $0.00
D0603 0% 7,696 $0.00
91319 0% 14 $0.00
D0602 0% 465 $0.00
D0601 0% 220 $0.00
99459 0% 25 $0.00
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units 0% 35 $0.00

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialGAGE, WELDON (EXECUTIVE VICE PRESIDENT/CFO)
Same official

Other billing entities under GAGE, WELDON

Full network →
ProviderLocationPaid
Texas Children's HospitalHouston, TX$277.28M
Children's Health SystemMilwaukee, WI$553K
Children's Hospital of WisconsinKenosha, WI$50K
Children's Hospital of WisconsinGreen Bay, WI$24K
Children's Hospital of WisconsinRacine, WI$10K
Children's Hospital of WisconsinAppleton, WI$9K
Children's Hospital of WisconsinWaukesha, WI$2K
Texas Children's HospitalAustin, TX$141.20

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.