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.

Clarksville Health System, LLC (NPI 1285689794)

Key Findings

Field	Value
Entity Type	Organization
Organization	Clarksville Health System, LLC
Address	651 Dunlop Ln
City	Clarksville
State	TN
ZIP	37040
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 23, 2006

Payer Source	Total Paid
Medicaid	$32.9M
Medicare	$0

Provider is effectively single‑payer in the available data: there is no Medicare billing on file while Total Medicaid revenue is $32.9M, indicating the organization's measurable claims activity is concentrated in the Medicaid program rather than dual Medicare/Medicaid operations. This payer mix implies fiscal exposure and reliance on Medicaid reimbursement rates and volumes for the provider's outpatient and emergency services revenue stream.

Revenue concentration is highly focused: the top three Medicaid codes (99283, 99284, 99285) together account for 83.3% of the provider’s total Medicaid revenue, with 99283 contributing $12M (37.3%), 99284 $10.9M (33.8%), and 99285 $3.9M (12.2%). This concentration suggests the facility’s Medicaid revenue base is dominated by emergency department E/M activity rather than elective inpatient or specialty clinic procedures.

Business and service‑line profile: the code mix — led by 99283/99284/99285 and supported by high volumes of basic labs and rapid IV administration codes (e.g., 85025, 80053, 96374, 96375) — is consistent with a high‑volume acute care and emergency department operation that provides diagnostic testing, CT imaging, and frequent IV therapies. Additional procedure codes such as 74177, 70450, 43239, 45380, and 45385 indicate availability of CT imaging and endoscopy services, suggesting the hospital operates a typical community acute care platform supporting both ED diagnosis and some procedural care.

Competitive standing in‑state for ED volumes is strong: 99283 ranks #12 of 611 providers in‑state (98th percentile) and 99284 ranks #18 of 625 (97th percentile), characterizing the hospital as a major statewide provider of low‑ to moderate‑complexity ED visits and placing it among the top providers in Tennessee for those visit types. By contrast, 99285 (high complexity ED visits) ranks #34 of 565 providers (94th percentile), which while still above average is described as a typical, unremarkable volume for that code relative to peers.

Statistical outliers and operational signal: code 96361 (IV fluids, additional hour) is marked an "extreme outlier, far above typical state volume for this code" — 12.4K claims generating $161.8K (0.5% of Medicaid revenue) and ranking #3 of 105 providers (98th percentile). This pattern may reflect sustained ED or observation‑area fluid management and prolonged treatment episodes compared with peers, reinforcing the ED/acute care operational emphasis.

High testing and specimen collection volumes: SARS‑CoV‑2 testing and related specimen codes show notable activity (87426: 26.2K claims, $680K, 2.1%, rank #4 of 354, 99th percentile; C9803: 18.4K claims, $184.1K, 0.6%, rank #3 of 30, 93rd percentile), alongside high volumes in point‑of‑care respiratory testing (87804, 87880). These figures point to substantial outpatient and ED testing throughput and public‑health testing demand handled by the facility.

Broad ancillary volume indicators: very high counts for specimen collection and basic diagnostics (36415: 88.2K claims, $88.2K, rank #14 of 1475, 99th percentile; 93005: 25.4K claims, $177.7K, rank #5 of 143, 97th percentile; 80053: 62.4K claims, $187.3K, rank #10 of 261, 97th percentile) suggest heavy front‑end patient throughput and routine monitoring services that support large ED and outpatient volumes. These operational characteristics align with the revenue concentration in ED E/M codes rather than specialty procedural margins.

Tenure and NPI history: NPI was enumerated on 2006‑05‑23 (~20 years ago), indicating the provider has an established presence in the market for approximately two decades; combined with the high Medicaid volumes and statewide ranks, this tenure supports interpretation of the hospital as a longstanding community acute care center with entrenched ED demand.

Medicaid: Complete Services Breakdown

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

109 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.	89,130	$140	$12M
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.	61,840	$180	$10.9M
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.	18,460	$210	$3.9M
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.	13,620	$100	$1.3M
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,…	26,150	$30	$680K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	19,700	$20	$453K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	530	$490	$259.1K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	990	$240	$235.9K
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…	77,540	$1	$232.6K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	1,490	$150	$216.8K

Showing 1–10 of 109

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

Clarksville Health System, LLC — 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

109 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	26	60	1,340	$50	$1.1M
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.	18	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.	12	610	570	$110	$884.4K
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.	34	570	640	$100	$637.8K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	55	100	400	$60	$524.7K
G0378	Hospital observation service, per hour	47	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.	44	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.	8	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.	15	120	3,760	$30	$225K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	50	70	250	$20	$215.6K

Showing 1–10 of 109

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Premier Medical Group PC	TN	General Practice Physician	$0	$20.1M
Advanced Therapy Solutions	TN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$9.9M
Progressive Directions Inc.	TN	Developmentally Disabled Services Day Training Agency	$0	$9.1M
County Of Montgomery-office Of County Judge	TN	Land Ambulance	$1.3M	$6.3M
Envoi Associates, LLC	TN	In Home Supportive Care Agency	$0	$3.2M
Latasha Garrett	TN	Pediatric Dentistry	$0	$3.1M
Barbara A Aquino Md PLLC	TN	Pediatrics Physician	$0	$2.6M
Valley Emergency Physicians Tennessee PC	TN	Emergency Medicine Physician	$0	$2.2M
Clarksville Eye Surgery Center	TN	Ambulatory Surgical Clinic/Center	$620.1K	$17.9K
Air Evac Ems, Inc.	TN	Air Ambulance	$481.4K	$63.3K

Clarksville Health System, LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References