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.

Specialty Physician Group LLC (NPI 1174842181)

Specialty Physician Group LLC is a cardiovascular disease physician provider located in Germantown, Tennessee. This profile covers 0 Medicare and 48 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	Specialty Physician Group LLC
Address	7460 Wolf River Blvd
City	Germantown
State	TN
ZIP	38138
Taxonomy	Cardiovascular Disease Physician
NPI Enumerated	June 1, 2010

Payer Source	Total Paid
Medicaid	$3.3M
Medicare	$0

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

48 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	35,590	$20	$854K
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…	34,650	$20	$831.6K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	30,540	$20	$580.3K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	122,870	$1	$245.7K
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…	10,190	$20	$152.8K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	4,700	$30	$150.5K
93295	In this service the provider evaluates from a remote location an implantable single, dual, or multiple lead defibrillator system. The service includes his interim analyses during a period of up to 90…	5,410	$10	$75.7K
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…	1,380	$50	$62.1K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	5,290	$10	$47.6K
93016	The provider supervises the recording of the electrical activity of the heart to examine any abnormality in its functioning by obtaining blood pressure and electrocardiograph readings at regular…	4,830	$10	$38.7K

Showing 1–10 of 48

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

Specialty Physician Group LLC — 11 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

48 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	93	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…	395	4,050	620	$30	$183.9K
93325	The provider performs Doppler echocardiography, a diagnostic procedure based on the Doppler effect of sound, color flow velocity mapping, a two–dimensional image representation of blood flow in the…	50	60	780	$30	$126.4K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	4	240	510	$50	$125.9K
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…	118	1,080	120	$80	$90.7K
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…	348	550	290	$30	$77K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	33	840	440	$20	$73K
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…	170	660	190	$60	$53.3K
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…	657	1,240	120	$60	$53.1K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	397	480	160	$50	$46.3K

Showing 1–10 of 48

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Methodist Healthcare - Memphis Hospitals	TN	General Acute Care Hospital	$0	$105.6M
Methodist Healthcare - Memphis Hospitals	TN	Children's Hospital	$0	$84.4M
Ut Lebonheur Pediatric Specialists, Inc.	TN	Pediatrics Physician	$0	$63.8M
Primary Care Group LLC	TN	Family Medicine Physician	$0	$23.5M
Methodist Healthcare - Olive Branch Hospital	MS	General Acute Care Hospital	$0	$18.1M
Alliance Health Services Inc.	TN	Durable Medical Equipment & Medical Supplies	$0	$11.2M
Methodist Inpatient Physicians LLC	TN	Internal Medicine Physician	$0	$4.8M
Lebonheur Patient Transportation	TN	Land Ambulance	$0	$4.5M
Memphis Neurology PLLC	TN	Neurology Physician	$0	$3.9M
Methodist Healthcare - Memphis Hospitals	TN	Children's Hospital	$0	$3.3M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Byram Healthcare Centers, Inc.	TN	Durable Medical Equipment & Medical Supplies	$0	$44.3M
Campbell Clinic, PC	TN	Orthopaedic Surgery Physician	$0	$28M
The West Clinic P.C.	TN	Specialist	$0	$16M
Poplar Avenue Clinic PLLC	TN	Gynecologic Oncology Physician	$0	$9.7M
Diagnostic Ultrasound Consultants	TN	Diagnostic Radiology Physician	$0	$8.5M
Mid-south Imaging & Therapeutics, P.A.	TN	Diagnostic Radiology Physician	$0	$8.2M
David Portnoy	TN	Hematology & Oncology Physician	$6.5M	$0
Stephen Huddleston	TN	Retina Specialist (Ophthalmology) Physician	$5.7M	$0
Stern Cardiovascular Foundation, Inc	TN	Cardiovascular Disease Physician	$0	$4.7M
G I Diagnostic And Therapeutic Center LLC	TN	Endoscopy Clinic/Center	$4.2M	$8.6K

Specialty Physician Group LLC — Billing Profile & Reimbursement Data

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Specialty Physician Group LLC — 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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