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.

Baptist Memorial Medical Group Inc (NPI 1306089206)

Key Findings

Field	Value
Entity Type	Organization
Organization	Baptist Memorial Medical Group Inc
Address	8970 Winchester Rd
City	Memphis
State	TN
ZIP	38125
Taxonomy	Internal Medicine Physician
NPI Enumerated	April 8, 2009

Payer Source	Total Paid
Medicaid	$35.6M
Medicare	$0

This provider is effectively single‑payer in the available claims data: Medicare shows no billing on file while total Medicaid revenue is $35.6M, indicating Medicaid is the dominant — and for our dataset, the only — payer recorded for this NPI. The absence of Medicare claims will materially shape analyses of payer mix, risk adjustment, and competitive comparisons that rely on Medicare populations.

Revenue is highly concentrated in a small set of evaluation-and-management and hospital care codes: the top three Medicaid codes (99214, 99213, 99233) together account for 44.2% of the provider’s total Medicaid revenue. Individually those codes are 99214: $6.2M (20.2%), 99213: $4.3M (14.0%), and 99233: $3.1M (10.0%), so nearly half of Medicaid dollars flow from a few high-volume visit types.

The code mix points to a large ambulatory primary care footprint with substantial inpatient follow-up activity. Very high volumes of 99214 (148K claims) and 99213 (110.1K claims) indicate heavy established‑patient clinic throughput and longitudinal care consistent with Internal Medicine practice, while 99233 (133.2K claims) and other inpatient E/M codes show the group also provides substantial hospital-based subsequent care.

Competitive standing within Tennessee is exceptional for several core services: 99214 ranks #16 of 3759 providers in-state at the 100th percentile (labeled an "extreme outlier"), 99213 is at the 99th percentile, and 99233 is #2 of 551 providers in-state at the 100th percentile (also an "extreme outlier"). Multiple other codes (for example 99223, 99239, 99232, 99391, 99392, 99395) rank in the 97th–100th percentiles, indicating the provider is a dominant statewide participant on many high-value Medicaid codes.

Beyond primary care and hospital E/M, the billing mix includes substantial preventive, pediatric, and vaccination activity (99391, 99392, 99393, 90460) and allied therapy and testing (97530, 92507, 96110). The presence of large claim volumes for 90460 (38.3K claims, $1.3M) and well-visit codes suggests routine preventive and childhood immunization services are a significant component of Medicaid work.

Obstetric and imaging services contribute nontrivial Medicaid revenue: 59400 generates $1.6M (5.3%) and ultrasound codes such as 76816, 76856, and 76819 together appear in the top 25 list, with rankings (e.g., 59400 at the 95th percentile) described as "notably above typical" state volume. This pattern signals the practice bills for prenatal/global delivery services and obstetric imaging in addition to primary care and inpatient follow-up.

Operationally, the high concentration of revenue in a few high-volume E/M and inpatient codes suggests revenue-cycle and clinical documentation priorities should focus on those line items. Given the labeling of several codes as "extreme outlier" or "notably above typical," payer contract management, utilization review, and coding quality assurance around 99214/99213/99233 and related inpatient codes should be considered primary levers for revenue and audit risk mitigation.

The NPI has long tenure in the dataset, registered 2009-04-08 (~17 years ago), which supports interpreting these high-volume patterns as established operational behavior rather than a transient billing spike. That longevity, combined with the statewide dominance on multiple codes, indicates this entity is an entrenched Medicaid provider with sustained, high-volume ambulatory and inpatient service delivery.

Medicaid: Complete Services Breakdown

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

327 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	147,960	$40	$6.2M
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…	110,140	$40	$4.3M
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…	133,240	$20	$3.1M
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	26,620	$70	$1.8M
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	1,360	$1,210	$1.6M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	23,660	$60	$1.5M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	29,480	$50	$1.3M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	17,800	$70	$1.3M
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.	38,310	$30	$1.3M
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…	24,880	$50	$1.1M

Showing 1–10 of 327

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

Baptist Memorial Medical Group Inc — 18 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

327 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	478	610	570	$110	$884.4K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	20	230	2,130	$40	$616.8K
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	5	80	100	$1,260	$405.3K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	29	340	1,400	$40	$354.2K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	15	60	320	$140	$346.9K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	11	100	670	$60	$342.9K
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	18	50	490	$50	$333.3K
43775	Using laparoscopic technique, the provider reduces the size of the stomach by removing the bulk of the stomach in a vertical fashion. This procedure leaves a long, cylindrical stomach without the…	2	10	80	$960	$314K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	420	440	530	$70	$282.3K
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	25	40	200	$20	$234.7K

Showing 1–10 of 327

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southeastern Emergency Physicians LLC	KY	Emergency Medicine Physician	$0	$208.5M
Baptist Memorial Hospital-desoto, Inc,	MS	General Acute Care Hospital	$0	$41.6M
Baptist Memorial Hospital North Mississippi, Inc	MS	General Acute Care Hospital	$0	$38.9M
Southeastern Emergency Physicians Of Memphis LLC	IL	Emergency Medicine Physician	$0	$26.5M
Baptist Minor Medical Centers Inc	TN	Internal Medicine Physician	$0	$3M
Yalobusha General Hospital	MS	General Acute Care Hospital	$0	$2.5M
George Woodman	TN	Surgery Physician	$1.1K	$2.3M
Yalobusha General Hospital	MS	Rural Health Clinic/Center	$0	$1.8M
William Sullivan	AL	Rheumatology Physician	$1.6M	$0
Usa Health Physician Billing Services LLC	AL	Pediatric Cardiology Physician	$0	$1.6M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Poplar Healthcare, PLLC	TN	Specialist	$0	$17.5M
Loving Care Inc	TN	In Home Supportive Care Agency	$0	$11.7M
All About Kids Pediatric Dentistry	TN	Pediatric Dentistry	$0	$5.7M
Keystone Memphis, LLC	TN	Psychiatric Hospital	$0	$4.5M
Richard Kinsey	TN	Anatomic Pathology & Clinical Pathology Physician	$3.3M	$147.3K
Sisterly Love Home Care Services,llc	TN	In Home Supportive Care Agency	$0	$3M
Innovative Behavior Services	TN	Behavior Analyst	$0	$2.5M
Ronald Michael	TN	Gastroenterology Physician	$1.5M	$0
Richard Roberts	TN	Anatomic Pathology & Clinical Pathology Physician	$1.3M	$790
Changhyun Choi	TN	Anatomic Pathology & Clinical Pathology Physician	$1.2M	$0

Baptist Memorial Medical Group Inc — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References