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.

Ut Regional One Physicians Inc (NPI 1093130585)

Ut Regional One Physicians Inc is a surgery physician provider located in Memphis, Tennessee. This profile covers 0 Medicare and 191 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	Ut Regional One Physicians Inc
Address	877 Jefferson Ave
City	Memphis
State	TN
ZIP	38103
Taxonomy	Surgery Physician
NPI Enumerated	February 20, 2014

Payer Source	Total Paid
Medicaid	$24.1M
Medicare	$0

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

191 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	157,690	$30	$5.4M
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.	34,020	$90	$3M
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.	37,300	$60	$2.4M
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…	51,450	$30	$1.5M
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…	39,800	$30	$1.3M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	19,140	$50	$976.2K
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…	20,130	$40	$865.4K
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…	6,810	$110	$735.2K
70496	The provider injects contrast material into a peripheral vein and images the blood vessels in the patient's head using computed tomographic scanning. Noncontrast images, if performed, are included in…	9,020	$80	$685.4K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	18,640	$40	$671K

Showing 1–10 of 191

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

Ut Regional One Physicians Inc — 14 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

191 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.	37	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.	113	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.	19	570	640	$100	$637.8K
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…	47	80	100	$1,260	$405.3K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	8	60	320	$140	$346.9K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	12	100	670	$60	$342.9K
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	15	50	490	$50	$333.3K
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.	128	180	480	$90	$245.5K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	7	150	390	$60	$220.9K
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.	136	170	340	$190	$206.8K

Showing 1–10 of 191

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Theoria Medical	MI	Internal Medicine Physician	$0	$9.6M
Eric Johnson	KY	Diagnostic Radiology Physician	$78.6K	$3.1M
Ut Methodist Physicians LLC	TN	Internal Medicine Physician	$0	$2.7M
Ut Regional One Physicians Inc	TN	Anesthesiology Physician	$0	$2.3M
Stanley Mathew	IA	Physical Medicine & Rehabilitation Physician	$1.7M	$31.9K
Ray Silao	AZ	Internal Medicine Physician	$921.6K	$691.2K
Michelle Alexandre	IL	Family Medicine Physician	$21.7K	$639.7K
Mark Brady	RI	Emergency Medicine Physician	$32.9K	$627.4K
Charles Welly	VA	Family Medicine Physician	$248.4K	$196.2K
Salil Joshi	TN	Vascular & Interventional Radiology Physician	$402.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Methodist Healthcare - Memphis Hospitals	TN	Children's Hospital	$0	$84.4M
Ut Lebonheur Pediatric Specialists, Inc.	TN	Pediatrics Physician	$0	$63.8M
Shelby County Health Care Corporation	TN	General Acute Care Hospital	$0	$56.1M
City Of Memphis General City Govt.	TN	Land Ambulance	$3.8M	$52M
Pediatric Emergency Specialists, PC	TN	Pediatric Emergency Medicine (Emergency Medicine) Physician	$0	$39.1M
Meritan, Inc	TN	Home Health Agency	$0	$16.9M
Lebonheur Patient Transportation	TN	Land Ambulance	$0	$4.5M
Pediatric Anesthesiologists P A	TN	Anesthesiology Physician	$0	$4.4M
University Of Tennessee	TN	Dentist	$0	$3.1M
Utmg Dermatopathology, LLC	TN	Clinical Medical Laboratory	$1.5M	$127.6K

Ut Regional One Physicians 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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