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.

Chattanooga Hamilton County Hospital Authority (NPI 1154751931)

Key Findings

Field	Value
Entity Type	Organization
Organization	Chattanooga Hamilton County Hospital Authority
Address	975 E 3rd St
City	Chattanooga
State	TN
ZIP	37403
Taxonomy	Internal Medicine Physician
NPI Enumerated	November 15, 2013

Payer Source	Total Paid
Medicaid	$27.9M
Medicare	$0

This provider is effectively a Medicaid-focused operation: there is no Medicare billing on file while Medicaid revenue totals $27.9M. The absence of Medicare activity means analyses of commercial/Medicare mix or dual-coverage behavior are not supported by the data — the organization should be treated as a single-payer (Medicaid) revenue profile for payer/competitive modeling.

Revenue is highly concentrated in a small set of outpatient evaluation-and-management codes: 99214 accounts for $8.5M (35.0% of Medicaid revenue), 99213 accounts for $4.2M (17.1%), and 99204 accounts for $1.3M (5.2%). The three codes together make up 57.3% of this provider's total Medicaid revenue, indicating most Medicaid dollars flow from routine new and established office visits rather than procedure-driven lines.

The code mix points to a large ambulatory primary care/internal medicine footprint supported by hospital-based services. High volumes in 99214 and 99213 (177.7K and 112.4K claims respectively) indicate heavy outpatient visit throughput, while presence of inpatient E/M codes such as 99223, 99222, 99232, and 99233 and neonatal codes 99469/99479/99480 signal integrated inpatient and newborn care capacity within the same billing entity.

The provider is a dominant statewide player for key visit codes: 99214 ranks #12 of 3759 in-state (100th percentile; extreme outlier) and 99213 ranks #32 of 4050 (99th percentile; extreme outlier). 99204 also ranks highly at #14 of 1078 (99th percentile; notably above typical state volume). These rankings identify the organization as a major source of Medicaid outpatient visits in Tennessee and suggest leverage in network negotiations focused on primary care capacity.

Several ancillary and procedure codes show similarly elevated state standing, reflecting a broad service portfolio beyond office visits. For example, 93306 (echocardiography) ranks #8 of 241 (97th percentile; notably above typical), 93010 (ECG interpretation) ranks #9 of 407 (98th percentile; notably above typical), and 97110 (therapeutic exercise) appears in the upper percentiles as well. At the same time, a few specialized neonatal codes (99469, 99480, 99479) are described as typical or unremarkable in percentile standing, indicating concentrated high-volume outpatient work coexisting with expected volumes for some NICU-related services.

The sheer claim volumes for top visit codes imply substantial operational capacity: 177.7K claims for 99214 and 112.4K claims for 99213 indicate high ambulatory throughput and likely robust scheduling, staffing, and access infrastructure to support established-patient follow-up. Payers evaluating utilization management or network adequacy should account for this high baseline of routine visit activity when modeling capacity or access requirements.

From a payer risk/opportunity perspective, the provider’s dependence on Medicaid ($27.9M with no Medicare revenue) concentrates reimbursement exposure to a single public payer. Given its statewide outlier status on multiple high-volume codes, the provider is an important Medicaid partner in Tennessee but also represents concentration risk if policy or program changes affect Medicaid reimbursement or patient volumes.

The provider has an established billing presence: the NPI was enumerated on 2013-11-15 (~13 years ago), indicating a sustained operating history in the state. That tenure, combined with the high-volume, high-percentile coding profile, supports treating this entity as a longstanding, high-capacity Medicaid service line in regional network analyses.

Medicaid: Complete Services Breakdown

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

272 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…	177,710	$50	$8.5M
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…	112,410	$40	$4.2M
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…	13,270	$100	$1.3M
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…	10,620	$90	$998.1K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	12,330	$70	$826.1K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	9,180	$80	$716K
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…	10,950	$70	$711.8K
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…	18,280	$40	$658K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	27,380	$20	$629.8K
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.	2,640	$240	$623.3K

Showing 1–10 of 272

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

Chattanooga Hamilton County Hospital Authority — 13 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

272 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	9	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.	7	20	1,380	$300	$2.7M
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	6	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.	7	20	890	$100	$997K
J0585	Injection, onabotulinumtoxina, 1 unit	12	20	200	$880	$709.1K
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	17	30	1,060	$130	$484.1K
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	8	10	1,440	$370	$450.5K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	47	360	350	$50	$414.4K
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.	327	340	1,400	$40	$354.2K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	224	440	530	$70	$282.3K

Showing 1–10 of 272

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chattanooga Hamilton County Hospital Authority	TN	General Acute Care Hospital	$0	$52.4M
Chattanooga Hamilton County Hospital Authority	TN	Critical Access Hospital	$0	$5.6M
Erlanger Health	TN	General Acute Care Hospital	$0	$3.3M
Erlanger Health	TN	Internal Medicine Physician	$0	$2.3M
Erlanger Behavioral Health, LLC	TN	Psychiatric Hospital	$0	$2.2M
Medical Foundation, Inc.	MS	Geriatric Medicine (Family Medicine) Physician	$0	$1.8M
Clint Kingsley	AL	Hematology & Oncology Physician	$1.6M	$22K
Robert Graham	TN	Hematology & Oncology Physician	$1.2M	$19.8K
Harsha Vardhana	TN	Medical Oncology Physician	$941.1K	$66.6K
Sreejit Nair	NC	Vascular Surgery Physician	$658K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Regional Obstetrical Consultants PC	TN	Maternal & Fetal Medicine Physician	$0	$14.2M
Tennessee River Physicians, PLLC	TN	Emergency Medicine Physician	$0	$3.9M
Southeastern Emergency Services Of Memphis, P.C.	TN	Emergency Medicine Physician	$0	$3.8M
Tennessee Interventional And Imaging Associates, PLLC	TN	Diagnostic Radiology Physician	$0	$3.4M
Hearth Hospice Of Tennessee, LLC	TN	Community Based Hospice Care Agency	$0	$2.8M
Sumana Nagireddy	TN	Hematology & Oncology Physician	$836.4K	$0
Brett Gerwin	TN	Ophthalmology Physician	$725.5K	$60
Michael Goodman	TN	Gastroenterology Physician	$473.6K	$0
Harigovinda Challa	TN	Diagnostic Radiology Physician	$154.9K	$257.6K
David Bowers	TN	Physical Medicine & Rehabilitation Physician	$410.4K	$0

Chattanooga Hamilton County Hospital Authority — Billing Profile & Reimbursement Data

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Chattanooga Hamilton County Hospital Authority — 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