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.

Memorial Health Care System Inc. (NPI 1083778633)

Memorial Health Care System Inc. is a general acute care hospital provider located in Hixson, Tennessee. This profile covers 0 Medicare and 49 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	Memorial Health Care System Inc.
Address	2051 Hamill Rd
City	Hixson
State	TN
ZIP	37343
Taxonomy	General Acute Care Hospital
NPI Enumerated	December 20, 2006

Payer Source	Total Paid
Medicaid	$2.4M
Medicare	$0

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

49 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.	9,210	$120	$1.1M
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.	9,400	$80	$742.4K
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.	960	$190	$178.6K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	2,430	$30	$60.7K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	10,870	$10	$54.3K
84484	The lab analyst performs the technical lab test typically using serum, plasma, or whole blood to quantitate troponin. Troponin is a protein labs commonly measure to verify a myocardial infarction and…	2,010	$10	$24.1K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	3,770	$10	$18.9K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	4,380	$1	$17.5K
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,…	250	$70	$17K
83690	The lab analyst measures the amount of lipase enzyme in the patient specimen. Lipase is an enzyme that the pancreas secretes to help in the absorption of fat.	2,530	$10	$15.2K

Showing 1–10 of 49

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

Memorial Health Care System Inc. — 0 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

49 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.	107	630	510	$120	$1.1M
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.	114	610	570	$110	$884.4K
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.	213	570	640	$100	$637.8K
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.	207	240	840	$20	$259.2K
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.	113	180	480	$90	$245.5K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	73	120	3,760	$30	$225K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	85	90	400	$30	$189K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	220	230	460	$20	$83K
C9803	Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	30	30	1,930	$10	$65.3K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	85	170	170	$40	$63.7K

Showing 1–10 of 49

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Memorial Health Care System Inc.	TN	General Acute Care Hospital	$0	$4.1M
Corinne Hinson	TN	Family Nurse Practitioner	$492.9K	$0
Gregory Bruce	TN	Clinical Cardiac Electrophysiology Physician	$315.9K	$0
Gregg Shander	TN	Clinical Cardiac Electrophysiology Physician	$257.8K	$0
Kelly Richardson	TN	Clinical Cardiac Electrophysiology Physician	$237.7K	$0
Michael Allan	TN	Clinical Cardiac Electrophysiology Physician	$225.9K	$2.6K
Samuel Jones	TN	Clinical Cardiac Electrophysiology Physician	$227.8K	$0
Newton Wiggins	TN	Clinical Cardiac Electrophysiology Physician	$213.4K	$0
Brian Mitchell	TN	Cardiovascular Disease Physician	$200.4K	$0
Sachin Phade	TN	Vascular Surgery Physician	$188.5K	$1K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Galen Medical Group, PC	TN	Internal Medicine Physician	$0	$10.2M
Agilitas Usa Inc	TN	Physical Therapy Clinic/Center	$0	$7.4M
Dental Center, Inc	TN	Dentist	$0	$7.4M
Lighthouse Kids Hixson, LLC	TN	Behavior Analyst	$0	$3.7M
Devon Ghodasra	TN	Retina Specialist (Ophthalmology) Physician	$3.6M	$0
Hixson Pediatric Dentistry PLLC	TN	Pediatric Dentistry	$0	$3.2M
Rohan Shah	TN	Retina Specialist (Ophthalmology) Physician	$2.9M	$0
Chattanooga Pain Management Center LLC	TN	Ambulatory Surgical Clinic/Center	$2.4M	$1.6K
Francis Decroos	TN	Retina Specialist (Ophthalmology) Physician	$2.3M	$0
Chelsea Schwind	TN	Dentist	$0	$2.2M

Memorial Health Care System 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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