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.

Maltman Medical Center LLC (NPI 1225586878)

Maltman Medical Center LLC is a nurse practitioner provider located in Knoxville, Tennessee. This profile covers 0 Medicare and 51 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	Maltman Medical Center LLC
Address	9051 Executive Park Dr Ste 202
City	Knoxville
State	TN
ZIP	37923
Taxonomy	Nurse Practitioner
NPI Enumerated	September 12, 2016

Payer Source	Total Paid
Medicaid	$2.7M
Medicare	$0

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

51 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J2315	Injection, naltrexone, depot form, 1 mg	1,930	$510	$981.5K
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…	17,740	$50	$816.2K
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…	2,900	$80	$234.6K
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…	3,560	$30	$117.6K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	1,600	$60	$100.9K
96160	The provider administers a questionnaire aimed at helping to identify a specific health risk to a patient, analyzes the results, assigns a score, and documents the findings. Use this code for each…	6,130	$10	$61.3K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	10,330	$1	$41.3K
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	6,600	$10	$39.6K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	7,240	$10	$36.2K
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…	2,820	$10	$31.1K

Showing 1–10 of 51

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

Maltman Medical Center LLC — 7 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

51 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J2315	Injection, naltrexone, depot form, 1 mg	1	10	190	$770	$474.5K
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.	523	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…	181	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…	844	4,050	620	$30	$183.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	431	510	240	$70	$133.7K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	45	60	270	$110	$121.6K
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…	64	1,080	120	$80	$90.7K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	119	260	300	$30	$84.6K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	392	420	150	$80	$81.8K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	328	380	270	$40	$78.3K

Showing 1–10 of 51

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Deborah L Curlee Communication Consultants Inc	TN	Speech-Language Pathologist	$0	$54.5M
Rha Health Services Tn LLC	TN	Developmentally Disabled Services Day Training Agency	$0	$31.7M
Parkwest Medical Center	TN	General Acute Care Hospital	$0	$30M
Preferred Care At Home	TN	In Home Supportive Care Agency	$0	$19M
Tennessee Ear, Nose & Throat Consultants, PC	TN	Otolaryngology Physician	$0	$9.2M
Nurturing Independence Inc	TN	In Home Supportive Care Agency	$0	$5.9M
Special Care Inc.	TN	Community Based Hospice Care Agency	$0	$5.1M
Childhelp, Inc.	TN	Community/Behavioral Health Agency	$0	$4.8M
Family Home Care Services, LLC	TN	In Home Supportive Care Agency	$0	$4.7M
East Tn Human Resource Agency	TN	Non-emergency Medical Transport (VAN)	$0	$3.9M

Maltman Medical Center LLC — Billing Profile & Reimbursement Data

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Maltman Medical Center 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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