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.

Vanderbilt University Medical Center (NPI 1104202761)

Field	Value
Entity Type	Organization
Organization	Vanderbilt University Medical Center
Address	1301 22nd Ave S
City	Nashville
State	TN
ZIP	37232
Taxonomy	Internal Medicine Physician
NPI Enumerated	August 6, 2015

Payer Source	Total Paid
Medicaid	$189.5M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and reports $189.5M in lifetime Medicaid revenue, making its public payer footprint effectively single‑payer Medicaid in the available data. Analysts should treat the Medicaid data as the primary lens for revenue and utilization patterns rather than a mixed Medicare/Medicaid profile.

Revenue is concentrated: the precomputed top three Medicaid codes account for 31.0% of the provider's total Medicaid revenue, indicating that a relatively small set of service lines drive a large share of the $189.5M Medicaid total. This concentration suggests targeted operational leverage in those high‑revenue code groups.

The code mix points to a large, multi‑service clinical operation combining high‑volume outpatient E/M and extensive neonatal/critical care capacity. High‑volume office visit codes such as 99214 (264.2K claims, $18.8M) and 99213 (288.5K claims, $15M) sit alongside neonatal critical care codes 99472 (25.1K claims, $9.6M) and 99469 (27.8K claims, $9.6M), implying both heavy ambulatory throughput and significant perinatal/inpatient acuity.

On a statewide competitive basis this provider is frequently a dominant participant: multiple codes are labeled extreme outliers and rank at or near the top in Tennessee. Examples include 99214 (ranks #4 of 3759 in‑state, 100th percentile; extreme outlier), 99213 (ranks #4 of 4050, 100th percentile; extreme outlier), and 99215 (ranks #1 of 663, 100th percentile; extreme outlier), which together indicate market leadership for common E/M services.

Pediatric, newborn, and NICU services are a clear strength. Neonatal follow‑up and subsequent newborn care are high revenue drivers (99472: 25.1K claims, $9.6M, ranks #2 of 11, 90th percentile; 99469: 27.8K claims, $9.6M, ranks #2 of 16, 93th percentile), and preventive pediatric codes (99391, 99392, 99393) also show large volumes and top state ranks, supporting a substantial pediatric preventive and inpatient newborn caseload.

Emergency and critical care volumes are substantial and above typical state levels, consistent with a high‑acuity facility. ED-level codes 99284 (97.1K claims, $8.9M, ranks #13 of 625, 98th percentile) and 99285 (67.7K claims, $8.7M, ranks #10 of 565, 98th percentile) sit alongside critical care 99291 (18.2K claims, $3.6M, ranks #1 of 162, 100th percentile; extreme outlier), indicating both high ED throughput and significant critical care delivery.

The provider’s service mix includes significant diagnostic and procedural capacity supporting complex care. Cardiac imaging codes such as 93303 (34.6K claims, $3.6M, ranks #1 of 29, 100th percentile; extreme outlier) and 93306 (34.6K claims, $2.5M, ranks #5 of 241, 98th percentile) plus pathology 88305 (26K claims, $2.3M) and anesthesia for delivery 01967 ($3M) reflect integrated imaging, lab, and perioperative services that align with tertiary care operations.

Operational tenure is established but not long historical: the NPI was enumerated on 2015-08-06 (~11 years ago). Combined with the very large claim counts reported for core codes (for example 99213 at 288.5K claims and 99214 at 264.2K claims), the data point to a high‑volume, high‑capacity organization that scaled rapidly over the enumeration period.

Medicaid: Complete Services Breakdown

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

475 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…	264,230	$70	$18.8M
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…	288,500	$50	$15M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	25,050	$380	$9.6M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	27,850	$340	$9.6M
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…	69,330	$130	$9.2M
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.	97,150	$90	$8.9M
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.	67,740	$130	$8.7M
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.	133,800	$60	$7.9M
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	66,610	$90	$6.3M
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…	94,440	$50	$4.5M

Showing 1–10 of 475

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

Vanderbilt University Medical Center — 21 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

475 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2023	Targeted case management; per month	13	10	11,790	$410	$75.3M
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	12	10	2,040	$430	$7.7M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	2	10	1,110	$340	$3.6M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	2	20	1,380	$300	$2.7M
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.	13	630	510	$120	$1.1M
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	5	10	1,710	$90	$1M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	3	20	890	$100	$997K
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.	5	610	570	$110	$884.4K
J0585	Injection, onabotulinumtoxina, 1 unit	11	20	200	$880	$709.1K
H0016	Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)	40	130	620	$200	$655.5K

Showing 1–10 of 475

Related Providers

Other providers that share a Tax Identification Number (TIN) with Vanderbilt University Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vanderbilt University Medical Center	TN	General Acute Care Hospital	$0	$137.7M
Vanderbilt University Medical Center	TN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$29.1M
Vanderbilt University Medical Center	TN	General Acute Care Hospital	$0	$8M
Antonia Kolokythas	TN	Oral and Maxillofacial Surgery (Dentist)	$0	$5.9M
Vanderbilt Integrated Providers, LLC	TN	Family Medicine Physician	$0	$4.3M
Heather Tamez	MD	Retina Specialist (Ophthalmology) Physician	$1.3M	$0
Kenneth Niermann	TN	Radiation Oncology Physician	$625.8K	$0
Stephen Kim	TN	Ophthalmology Physician	$608.9K	$0
Corbin Johnson	TN	Radiation Oncology Physician	$577.1K	$0
Avni Finn	TN	Ophthalmology Physician	$504.5K	$0

Nearby Providers

Other providers in the same ZIP code as Vanderbilt University Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Han-chih Chang	TN	Radiation Oncology Physician	$2.6M	$0
Emily Carpenter	TN	Nurse Practitioner	$747.9K	$0
Dinesh Gupta	TN	Cardiovascular Disease Physician	$397.9K	$80.2K
Dong Kim	TN	Radiation Oncology Physician	$469.4K	$0
Anthony Cmelak	TN	Radiation Oncology Physician	$391.9K	$0
Ryszard Dworski	TN	Allergy & Immunology Physician	$376.5K	$2.4K
Nathan Podoll	TN	Ophthalmology Physician	$363.9K	$0
Brian Thurber	TN	Diagnostic Radiology Physician	$356K	$0
Reagan Leverett	TN	Diagnostic Radiology Physician	$337.1K	$0
Collier King	TN	Diagnostic Radiology Physician	$336.3K	$0

Vanderbilt University Medical Center — Billing Profile & Reimbursement Data

Sign up for Vanderbilt University Medical Center — Billing Profile & Reimbursement Data policy alerts

Vanderbilt University Medical Center — Billing Profile & Reimbursement Data

Sign up for Vanderbilt University Medical Center — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References