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.

Southeastern Physician Services PC (NPI 1083835441)

Southeastern Physician Services PC is a hospitalist physician provider located in Oak Ridge, Tennessee. This profile covers 0 Medicare and 27 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	Southeastern Physician Services PC
Address	990 Oak Ridge Tpke
City	Oak Ridge
State	TN
ZIP	37830
Taxonomy	Hospitalist Physician
NPI Enumerated	May 2, 2007

Payer Source	Total Paid
Medicaid	$14.7M
Medicare	$0

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

27 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	228,090	$30	$5.7M
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…	184,120	$20	$3.5M
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…	61,110	$50	$3M
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	55,280	$30	$1.5M
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	4,900	$70	$328K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	3,740	$40	$164.5K
99497	The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…	10,580	$20	$158.7K
99220	N/A	1,390	$50	$66.9K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	2,570	$20	$56.4K
99254	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider spends…	590	$90	$51.5K

Showing 1–10 of 27

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

Southeastern Physician Services PC — 9 of 24 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

27 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	3,548	3,760	610	$40	$202.3K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	179	310	110	$70	$142.8K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	12	160	110	$90	$96K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	62	90	100	$140	$77.4K
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…	1	550	290	$30	$77K
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…	1	840	440	$20	$73K
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…	1	480	160	$50	$46.3K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	24	310	160	$40	$37.9K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	113	260	280	$20	$35.4K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	1	280	110	$30	$29K

Showing 1–10 of 27

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Endeavor Health Medical Group	IL	Clinical Medical Laboratory	$0	$7.7M
Endeavor Health Clinical Operations	IL	General Acute Care Hospital	$0	$7.1M
Jeffrey Parnell	IL	Retina Specialist (Ophthalmology) Physician	$2.6M	$27.5K
Karen Kaul	IL	Anatomic Pathology & Clinical Pathology Physician	$16.2K	$1.7M
Roop Gupta	IL	Gastroenterology Physician	$237.3K	$1.3M
Kenneth Resnick	IL	Retina Specialist (Ophthalmology) Physician	$1.4M	$74.2K
Vassilios Dimitropoulos	IN	Dermatology Physician	$1.1M	$293.6K
Uzoma Okoli	IL	Psychiatry Physician	$129.4K	$1.2M
Arun Nagaraju	IL	Diagnostic Radiology Physician	$283.9K	$908.4K
Shah Alam	IL	Hospitalist Physician	$96.7K	$1M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ridgeview Psychiatric Hospital And Center, Inc.	TN	Psychiatric Hospital	$0	$42M
Emory Valley Center	TN	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$11.3M
Discover Diagnostic Laboratory, LLC	TN	Clinical Medical Laboratory	$363.5K	$4.7M
Children's Clinic	TN	Pediatric Adolescent Medicine Physician	$0	$4.7M
East Tennessee Ear, Nose & Throat Specialists, PC	TN	Otolaryngology Physician	$0	$2.6M
East Tennessee Children's Primary Care Center, Inc.	TN	Pediatrics Physician	$0	$2.4M
The Eye Surgery Center Of Oak Ridge LLC	TN	Clinic/Center	$783K	$3.3K
Surgery Center Of Oak Ridge, LLC	TN	Ambulatory Surgical Clinic/Center	$241K	$493.4K
Brian Burnett	TN	Family Nurse Practitioner	$661.1K	$0
Joseph Eatherly	TN	Specialist	$394.3K	$3.9K

Southeastern Physician Services PC — Billing Profile & Reimbursement Data

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Southeastern Physician Services PC — 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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