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.

Shelby County Health Care Corporation (NPI 1144213117)

Field	Value
Entity Type	Organization
Organization	Shelby County Health Care Corporation
Address	877 Jefferson Ave
City	Memphis
State	TN
ZIP	38103
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 25, 2005

Payer Source	Total Paid
Medicaid	$56.1M
Medicare	$0

Key Findings

SHELBY COUNTY HEALTH CARE CORPORATION reports no Medicare billing on file and $56.1M in lifetime Medicaid revenue, making it effectively a single-payer (Medicaid) billing profile in the available data. The provider’s NPI was enumerated on 2005-08-25 (~21 years ago), indicating a multi-decade presence in the market but with current revenue concentrated in Medicaid claims.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 71.0% of the provider’s total Medicaid revenue, driven by G0463 ($14M, 28.1%), 99284 ($12.3M, 24.7%), and 99283 ($9M, 18.1%). This concentration shows that a small set of outpatient clinic and ED evaluation-and-management codes dominate the organization’s Medicaid receipts.

The code mix signals a hybrid outpatient clinic and emergency department operational model. G0463 (hospital outpatient clinic visit) is the single largest revenue code at $14M, while 99284 and 99283 (ED E/M codes) together contribute $21.3M, indicating substantial ED throughput and concurrent reliance on hospital outpatient clinic visits for assessment and management.

G0463 is a statewide outlier: it ranks #2 of 62 providers in Tennessee (98th percentile; labeled an "extreme outlier") and represents 28.1% of the provider’s Medicaid revenue, which suggests the hospital is a dominant destination for outpatient clinic assessment and management visits within the state. That volume is far above typical state activity for this code and likely reflects a strategic strength or referral role in outpatient evaluation.

The emergency-department E/M codes show above-average statewide volume but are not as singularly dominant as G0463. 99284 ranks #35 of 625 (95th percentile) and 99283 ranks #30 of 611 (95th percentile), which positions the provider as a high-volume ED participant relative to peers but within a broad cohort of similarly busy ED providers across the state. 99285 is also present ($5.9M, 11.9% of Medicaid revenue) and ranks in the 91st percentile, indicating some higher-acuity ED care is billed as well.

Ancillary and laboratory services are notable contributors and show several extreme-volume signals. High-claim lab and procedure codes such as 36415 (124.1K claims, $248.2K revenue; ranks #8 of 1475, 100th percentile; extreme outlier), 96372 (22.5K claims, $337.9K revenue; ranks #12 of 1274, 99th percentile; extreme outlier), 80048 (69.1K claims, $207.2K revenue; ranks #4 of 174, 98th percentile; extreme outlier), and 83735 (52.4K claims, $209.5K revenue; ranks #3 of 230, 99th percentile; extreme outlier) point to large-scale specimen collection, routine labs, and frequent IV or IM therapeutic administrations. These volumes are consistent with a high-throughput ED and outpatient diagnostic operation.

Observation and maternal-fetal service lines are also meaningful components of activity. G0378 (hospital observation service) appears with $794.5K and ranks #3 of 96 (98th percentile; notably above typical state volume), while obstetric imaging codes such as 76816 ($879.7K, rank #8 of 148, 95th percentile) and 59025 ($1M, rank #8 of 138, 95th percentile) indicate the provider delivers substantial perinatal monitoring and follow-up ultrasound services. Together these codes suggest capacity for short-stay observation and obstetric care alongside ED and clinic services.

From a contracting and operational perspective, the combination of no Medicare revenue on file and a $56.1M Medicaid base with 71.0% of Medicaid revenue tied to three codes represents both a concentrated revenue stream and a potential exposure: the provider appears well-established in outpatient clinic visits and ED services within Tennessee but depends heavily on a narrow set of Medicaid-coded services for the majority of its reported revenue. Analysts should treat the provider as a Medicaid-centric, high-throughput ED/outpatient clinic operator when evaluating competitive positioning, reimbursement sensitivity, or network negotiations.

Medicaid: Complete Services Breakdown

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

312 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	333,920	$40	$14M
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.	38,010	$320	$12.3M
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.	43,860	$210	$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.	12,690	$470	$5.9M
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	8,610	$120	$1M
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	17,950	$50	$879.7K
G0378	Hospital observation service, per hour	6,570	$120	$794.5K
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.	5,080	$140	$696K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	103,330	$10	$620K
0241U	N/A	4,900	$90	$445.9K

Showing 1–10 of 312

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

Shelby County Health Care Corporation — 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

312 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	2	10	40	$220	$3.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	2	60	1,340	$50	$1.1M
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.	35	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.	30	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.	50	570	640	$100	$637.8K
88185	The lab analyst performs the technical component of a flow cytometry procedure using cell surface, cytoplasmic, or nuclear markers to characterize cells and aid clinicians in diagnosing patients with…	2	10	770	$140	$500.5K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	213	340	1,400	$40	$354.2K
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…	12	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.	20	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…	27	50	490	$50	$333.3K

Showing 1–10 of 312

Related Providers

Other providers that share a Tax Identification Number (TIN) with Shelby County Health Care Corporation, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kurt Tauer	TN	Medical Oncology Physician	$3.9M	$0
Jason Chandler	TN	Medical Oncology Physician	$3.8M	$0
Bradley Somer	TN	Hematology & Oncology Physician	$2.8M	$0
Robert Johnson	TN	Hematology & Oncology Physician	$2.8M	$0
Mark Reed	TN	Gynecologic Oncology Physician	$2.3M	$0
Daniel Vaena	TN	Medical Oncology Physician	$1.5M	$0
Michael Ulm	TN	Gynecologic Oncology Physician	$1.1M	$0
Todd Tillmanns	TN	Gynecologic Oncology Physician	$1.1M	$0
Allen Ardestani	TN	Neuroradiology Physician	$955.9K	$0
Chika Obele	TN	Vascular & Interventional Radiology Physician	$686.6K	$0

Nearby Providers

Other providers in the same ZIP code as Shelby County Health Care Corporation, ranked by combined Medicare and Medicaid revenue.

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
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
Ut Regional One Physicians Inc	TN	Surgery Physician	$0	$24.1M
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
Ut Regional One Physicians Inc	TN	Anesthesiology Physician	$0	$2.3M

Shelby County Health Care Corporation — Billing Profile & Reimbursement Data

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Shelby County Health Care Corporation — Billing Profile & Reimbursement Data

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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