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.

Knox County Goverment (NPI 1225305600)

Knox County Goverment is a public health or welfare agency provider located in Knoxville, Tennessee. This profile covers 0 Medicare and 68 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	Knox County Goverment
Address	140 Dameron Ave.
City	Knoxville
State	TN
ZIP	37917
Taxonomy	Public Health or Welfare Agency
NPI Enumerated	November 29, 2011

Payer Source	Total Paid
Medicaid	$2.6M
Medicare	$0

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

68 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	21,330	$40	$938.4K
99401	At an encounter separate from a preventive medicine visit, the provider offers counseling related to subjects appropriate for the patient’s age, family history, and areas of concern. The subjects…	15,010	$30	$390.3K
J1050	Injection, medroxyprogesterone acetate, 1 mg	5,840	$50	$268.5K
99402	At an encounter separate from a preventive medicine visit, the provider offers counseling related to subjects appropriate for the patient’s age, family history, and areas of concern. The subjects…	3,450	$40	$148.3K
90473	In this procedure, the provider administers a live attenuated vaccine through intranasal or oral route.	6,670	$20	$100.1K
90651	This code represents a nonavalent human papillomavirus (HPV) vaccine product administered into the muscle to protect against HPV infection. The vaccine protects against nine HPV types (6, 11, 16, 18,…	4,160	$20	$91.4K
90697	This code represents a combination vaccine product administered into the muscle to protect against six diseases: diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b (Hib), and…	1,230	$50	$66.6K
90677	This code represents a vaccine product administered intramuscularly to protect against pneumococcal disease, a bacterial infection. This is a 20–valent vaccine, protecting against 20 strains of the…	890	$70	$62.5K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	5,500	$10	$55K
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…	1,650	$30	$52.7K

Showing 1–10 of 68

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

Knox County Goverment — 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

68 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	39	610	1,220	$40	$206K
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…	1,320	4,050	620	$30	$183.9K
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…	626	660	190	$60	$53.3K
99384	The provider performs a well–patient visit for an adolescent who is between the ages of 12 and 17 who meets the definition of new patient.	64	80	60	$90	$43.1K
J1050	Injection, medroxyprogesterone acetate, 1 mg	1	60	170	$40	$32.1K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	79	310	100	$70	$31.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	318	1,170	170	$20	$23.8K
99403	At an encounter separate from a preventive medicine visit, the provider offers counseling related to subjects appropriate for the patient’s age, family history, and areas of concern. The subjects…	4	10	80	$110	$21.5K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	41	170	240	$10	$21.4K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	414	1,270	470	$10	$19.2K

Showing 1–10 of 68

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Megan Edwards	TN	Infectious Disease Physician	$13.1K	$0
Warren Sayre	TN	Family Medicine Physician	$590	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Helen Ross Mcnabb Center	TN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$198.7M
Knoxville Hma Physician Management, LLC	TN	Pulmonary Disease Physician	$0	$8.7M
University Of Tn Medical Center Home Care Services, LLC	TN	Community Based Hospice Care Agency	$0	$7.8M
Sertoma Center, Inc.	TN	Developmentally Disabled Services Day Training Agency	$0	$7.4M
Michael Chavin	TN	Pain Medicine (Anesthesiology) Physician	$38.9K	$1.1M
Nilesh Patel	TN	Radiation Oncology Physician	$329.6K	$0
Srinivas Boppana	TN	Radiation Oncology Physician	$324.8K	$0
Douglas Luttrell	TN	Nurse Practitioner	$145.3K	$0
Robert Hancock	TN	Podiatrist	$129.5K	$0
Heather Sandberg	TN	Podiatrist	$128.7K	$0

Knox County Goverment — Billing Profile & Reimbursement Data

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Knox County Goverment — 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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