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 Tennessee for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Tennessee 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. Tennessee (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.

West Tennessee Medical Group Inc (NPI 1053615955)

West Tennessee Medical Group Inc is a internal medicine physician provider located in Jackson, Tennessee. This profile covers 0 Medicare and 164 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	West Tennessee Medical Group Inc
Address	620 Skyline Dr
City	Jackson
State	TN
ZIP	38301
Taxonomy	Internal Medicine Physician
NPI Enumerated	January 6, 2011

Payer Source	Total Paid
Medicaid	$8.2M
Medicare	$0

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

164 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…	50,370	$30	$1.6M
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…	37,180	$40	$1.4M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	35,120	$20	$632.2K
J0585	Injection, onabotulinumtoxina, 1 unit	990	$600	$600.4K
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	330	$1,380	$453.4K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	9,210	$50	$451.4K
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…	6,320	$60	$404.3K
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…	5,110	$60	$286K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	10,330	$30	$258.2K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	2,180	$90	$194.3K

Showing 1–10 of 164

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Tennessee providers billing the same CPT/HCPCS codes.

Claims Volume vs. Tennessee Distribution

West Tennessee Medical Group Inc — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

164 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	242	610	570	$110	$884.4K
J0585	Injection, onabotulinumtoxina, 1 unit	5	20	200	$880	$709.1K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	245	360	350	$50	$414.4K
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	22	80	100	$1,260	$405.3K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	216	240	840	$20	$259.2K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	20	170	340	$190	$206.8K
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.	459	610	1,220	$40	$206K
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…	83	3,760	610	$40	$202.3K
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…	83	4,050	620	$30	$183.9K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	351	350	1,060	$30	$173.8K

Showing 1–10 of 164

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jackson Madison County General Hospital	TN	General Acute Care Hospital	$0	$46.6M
Jackson-madison County General Hospital	TN	Land Ambulance	$5.1M	$13M
Jackson-madison County General Hospital	TN	Community/Retail Pharmacy	$0	$7.4M
Stephen Huddleston	TN	Retina Specialist (Ophthalmology) Physician	$5.7M	$0
Wt Medical Associates	TN	Rural Health Clinic/Center	$0	$5.5M
Wt Medical Associates	TN	Internal Medicine Physician	$0	$4.9M
Scott Sullivan	TN	Retina Specialist (Ophthalmology) Physician	$3M	$0
Wt Medical Associates	TN	Rural Health Clinic/Center	$0	$2.5M
Salar Rafieetary	TN	Retina Specialist (Ophthalmology) Physician	$2.1M	$0
Rachel Robinson	TN	Family Nurse Practitioner	$2.1M	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pathways Of Tennessee, Inc.	TN	Clinic/Center	$0	$30.6M
Emergency Medical Care Facilities PC	TN	Emergency Medicine Physician	$0	$19.7M
A Plus Care Solutions Incorporated	TN	In Home Supportive Care Agency	$0	$18.4M
Mid-south Perinatal Associates PC	TN	Maternal & Fetal Medicine Physician	$0	$11.6M
Wt University Medical Associates Inc	TN	Family Medicine Physician	$0	$7.5M
Shavetta Conner	TN	Public Health & General Preventive Medicine Physician	$8.1K	$4.9M
West Tennessee Healthcare Hospitalists Inc	TN	Hospitalist Physician	$0	$4.3M
Home Medical Products, Inc.	TN	Oxygen Equipment & Supplies (DME)	$0	$3.6M
Pathways Of Tennessee, Inc.	TN	Psychiatric Hospital	$0	$3.3M
William Priester	TN	Ophthalmology Physician	$3.2M	$0

West Tennessee Medical Group Inc — 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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