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.

Martin Health (NPI 1275505372)

Martin Health is a general acute care hospital provider located in Martin, Tennessee. This profile covers 0 Medicare and 76 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	Martin Health
Address	161 Mount Pelia Rd
City	Martin
State	TN
ZIP	38237
Taxonomy	General Acute Care Hospital
NPI Enumerated	February 2, 2006

Payer Source	Total Paid
Medicaid	$3.9M
Medicare	$0

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

76 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	10,380	$140	$1.4M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	8,110	$170	$1.4M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	3,230	$170	$542.1K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	15,600	$10	$78K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	110	$660	$74.9K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	10,850	$1	$43.4K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	20,290	$1	$40.6K
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…	4,600	$10	$32.2K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	1,280	$20	$30.8K
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…	220	$100	$22.5K

Showing 1–10 of 76

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

Martin Health — 1 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

76 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	117	630	510	$120	$1.1M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	105	610	570	$110	$884.4K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	24	30	410	$520	$719.2K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	111	570	640	$100	$637.8K
G0378	Hospital observation service, per hour	83	100	410	$210	$264K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	114	240	840	$20	$259.2K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	158	180	480	$90	$245.5K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	87	120	3,760	$30	$225K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	43	90	400	$30	$189K
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…	152	240	510	$50	$125.9K

Showing 1–10 of 76

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ashraf Alqaqa	TN	Cardiovascular Disease Physician	$72.2K	$0
John Baltz	TN	Family Nurse Practitioner	$41.6K	$17.2K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Martin Children's Clinic, LLC	TN	Rural Health Clinic/Center	$0	$3.9M
Northwest Tennessee Human Resource Agency	TN	Non-emergency Medical Transport (VAN)	$0	$2.9M
Air Evac Ems Inc	TN	Air Ambulance	$997.3K	$285.5K
City Of Martin Tennessee	TN	Land Ambulance	$320.2K	$338.9K
Michael Chua	TN	Physical Therapist	$235.1K	$0
Kendell Kessler	TN	Physical Medicine & Rehabilitation Physician	$194.1K	$0
Anna Hopla	TN	Nephrology Physician	$179.9K	$0
Kenneth Carr	TN	Family Medicine Physician	$162.7K	$0
Seth Coleman	TN	Physician Assistant	$161.5K	$0
Frances Bynum	TN	Optometrist	$121.8K	$0

Martin Health — Billing Profile & Reimbursement Data

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Martin Health — 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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