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.

Tristate Obgyn, PC (NPI 1104274091)

Tristate Obgyn, PC is a obstetrics & gynecology physician provider located in Memphis, Tennessee. This profile covers 0 Medicare and 26 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	Tristate Obgyn, PC
Address	3337 Kirby Pkwy
City	Memphis
State	TN
ZIP	38115
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	June 1, 2016

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.

26 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	970	$1,180	$1.1M
59510	In this global service, the provider provides all of the antepartum care, admission to the hospital for delivery, delivery of the fetus and placenta via an abdominal incision, and inpatient and…	260	$990	$257.9K
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…	6,100	$40	$219.5K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	1,890	$70	$128.3K
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	1,670	$50	$80.3K
76817	The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.	1,590	$50	$79.4K
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…	990	$80	$78K
76801	In this procedure, the provider performs a real time or live image, ultrasound of a pregnant uterus for examination of the first or a single fetus and mother during the first trimester, or less than…	1,340	$50	$72.4K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	2,130	$30	$70.2K
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…	1,140	$60	$66.4K

Showing 1–10 of 26

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

Tristate Obgyn, PC — 0 of 23 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

26 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	10	80	100	$1,260	$405.3K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	39	150	390	$60	$220.9K
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…	1,860	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…	599	4,050	620	$30	$183.9K
59510	In this global service, the provider provides all of the antepartum care, admission to the hospital for delivery, delivery of the fetus and placenta via an abdominal incision, and inpatient and…	4	30	50	$1,230	$164.2K
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…	158	1,080	120	$80	$90.7K
76817	The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.	24	120	300	$60	$89.7K
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	21	150	210	$70	$85.6K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	39	140	470	$40	$54.9K
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…	181	1,240	120	$60	$53.1K

Showing 1–10 of 26

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Comforting Angels Home Care Services	TN	Home Health Agency	$0	$12.9M
Darsalud Community Center Inc	TN	General Practice Physician	$0	$12.4M
Co-med Health Care Services	TN	Home Health Agency	$0	$9.7M
My Faith Inc	TN	In Home Supportive Care Agency	$0	$7.5M
Best Nurses Inc	TN	Home Health Agency	$0	$6.7M
Good Hands Community Care LLC	TN	In Home Supportive Care Agency	$0	$5.3M
Victory Medical Equipment And Supplies, Inc.	TN	Durable Medical Equipment & Medical Supplies	$0	$5M
Pediatric Partners Of Memphis, LLC	TN	Pediatrics Physician	$0	$4.5M
Newstart Family And Obstetrical Care, LLC	TN	Obstetrics Physician	$0	$3.4M
Jacob Stegeman	TN	Dentist	$0	$3.3M

Tristate Obgyn, PC — Billing Profile & Reimbursement Data

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Tristate Obgyn, 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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