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 Kentucky for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Kentucky 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. Kentucky (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.

T J Health Columbia Inc (NPI 1134585656)

T J Health Columbia Inc is a general acute care hospital provider located in Columbia, Kentucky. This profile covers 0 Medicare and 163 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	T J Health Columbia Inc
Address	901 Wellness Way
City	Columbia
State	KY
ZIP	42728
Taxonomy	General Acute Care Hospital
NPI Enumerated	January 13, 2016

Payer Source	Total Paid
Medicaid	$11.5M
Medicare	$0

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

163 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.	9,590	$220	$2.1M
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.	10,670	$140	$1.5M
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.	4,880	$220	$1.1M
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.	1,800	$440	$790.2K
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.	990	$480	$473.7K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	4,860	$100	$471.1K
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.	2,870	$160	$449.8K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	9,240	$30	$295.7K
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.	31,110	$10	$280K
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.	3,370	$80	$269.2K

Showing 1–10 of 163

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Kentucky providers billing the same CPT/HCPCS codes.

Claims Volume vs. Kentucky Distribution

T J Health Columbia Inc — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

163 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.	124	280	7,150	$150	$3M
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.	118	240	4,710	$150	$2.6M
G0483	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…	46	70	1,650	$100	$2M
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.	108	280	5,700	$120	$2M
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.	105	180	1,870	$280	$1.5M
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.	109	170	2,610	$250	$1M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	74	110	8,390	$50	$749.1K
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.	238	340	2,700	$40	$673.3K
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.	94	180	2,960	$110	$672.4K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	78	100	5,870	$70	$670.3K

Showing 1–10 of 163

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mark Risen	KY	Primary Podiatric Medicine Podiatrist	$170K	$444.7K
Barret Lessenberry	KY	Orthopaedic Surgery Physician	$111.9K	$172.7K
Vivekanand Neginhal	KY	Orthopaedic Surgery Physician	$250.5K	$0
Venkata Reddy	KY	Cardiovascular Disease Physician	$236.2K	$0
Harikrishnan Damodaran Nair	KY	Interventional Cardiology Physician	$234.8K	$0
Brian Elmlinger	KY	Orthopaedic Surgery Physician	$99.5K	$123.4K
Zakare Salifu	KY	Cardiovascular Disease Physician	$115.6K	$0
Omar Mahmoud	KY	Pulmonary Disease Physician	$66.8K	$0
Klark Turpen	KY	Sleep Medicine (Internal Medicine) Physician	$61.8K	$0
Jacob Jaco	IN	Physician Assistant	$25.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mccloud Inc	KY	Adult Day Care Clinic/Center	$0	$41.1M
Wilkerson Consulting Psc	KY	Adult Day Care Clinic/Center	$0	$8.8M
Adair County Ambulance Service	KY	Land Ambulance	$435.6K	$656.3K
Jacob Burton	KY	Optometrist	$40.9K	$721K
Sarai Williams	KY	Optometrist	$29K	$496.5K
Charles Giles	KY	Internal Medicine Physician	$289.6K	$4.4K
Katie Aaron	KY	Family Nurse Practitioner	$47.8K	$0
Anthony Grant	KY	Chiropractor	$42K	$780

T J Health Columbia Inc — Billing Profile & Reimbursement Data

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T J Health Columbia 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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