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.

Cherokee Health Systems (NPI 1174760920)

Cherokee Health Systems is a federally qualified health center (fqhc) provider located in Knoxville, Tennessee. This profile covers 0 Medicare and 49 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	Cherokee Health Systems
Address	2018 Western Ave
City	Knoxville
State	TN
ZIP	37921
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	January 15, 2009

Payer Source	Total Paid
Medicaid	$4.7M
Medicare	$0

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

49 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S0280	Medical home program, comprehensive care coordination and planning, initial plan	28,060	$150	$4.2M
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…	4,300	$30	$133.3K
90832	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…	2,220	$50	$108.7K
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…	3,200	$30	$79.9K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	4,480	$10	$58.3K
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.	880	$40	$38K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	2,520	$10	$22.7K
G0511	Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral…	4,410	$1	$17.6K
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…	240	$70	$16.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	90	$80	$6.9K

Showing 1–10 of 49

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

Cherokee Health Systems — 0 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

49 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S0280	Medical home program, comprehensive care coordination and planning, initial plan	20	40	22,180	$140	$21.3M
J2315	Injection, naltrexone, depot form, 1 mg	4	10	190	$770	$474.5K
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…	209	360	350	$50	$414.4K
90832	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…	65	300	480	$30	$221.2K
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.	352	610	1,220	$40	$206K
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…	817	3,760	610	$40	$202.3K
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…	500	520	470	$70	$187K
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…	744	4,050	620	$30	$183.9K
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…	447	480	580	$60	$174.8K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	237	310	110	$70	$142.8K

Showing 1–10 of 49

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cherokee Health Systems	TN	Federally Qualified Health Center (FQHC)	$0	$97.7M
Melody Stump	TN	Family Nurse Practitioner	$83K	$0
Ryan Roberts	TN	Gastroenterology Physician	$82.5K	$0
Guy Smoak	TN	Family Medicine Physician	$47.2K	$0
Wimberly Thompson	TN	Clinical Social Worker	$35.4K	$0
Marcella Dunaway	TN	Clinical Psychologist	$27.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Phdc Of Knoxville, P.C.	TN	General Practice Dentistry	$0	$23.5M
Knoxville Home Therapies LLC	TN	Home Infusion Therapy Pharmacy	$0	$11.7M
Drd Management, Inc	TN	Substance Use Disorder Rehabilitation Clinic/Center	$389.5K	$8.5M
Oxygen And Sleep Associates, Inc.	TN	Oxygen Equipment & Supplies (DME)	$0	$8.6M
Drd Management, Inc	TN	Substance Use Disorder Rehabilitation Clinic/Center	$404K	$6.9M
Hoya Optical Labs Of America, Inc	TN	Eyewear Supplier	$0	$4.2M
Lincare Inc.	TN	Durable Medical Equipment & Medical Supplies	$0	$2.3M
Michael Allee	TN	Optometrist	$22.2K	$237K
Heather Hamstra	TN	Nurse Practitioner	$156.4K	$0
Jamie Ligon	TN	Physical Therapist	$81.3K	$0

Cherokee Health Systems — Billing Profile & Reimbursement Data

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Cherokee Health Systems — 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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