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.

Galen Medical Group, PC (NPI 1346250057)

Galen Medical Group, PC is a internal medicine physician provider located in Hixson, Tennessee. This profile covers 0 Medicare and 116 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	Galen Medical Group, PC
Address	4976 Alpha Ln
City	Hixson
State	TN
ZIP	37343
Taxonomy	Internal Medicine Physician
NPI Enumerated	August 8, 2006

Payer Source	Total Paid
Medicaid	$10.2M
Medicare	$0

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

116 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	62,460	$40	$2.2M
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…	23,410	$50	$1.2M
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	5,730	$140	$790.7K
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.	15,990	$50	$735.3K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	18,740	$40	$693.5K
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…	10,410	$60	$665.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	7,960	$60	$501.2K
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…	8,640	$50	$440.6K
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…	7,110	$60	$405.2K
95117	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives 2 or more injections at a single visit.	43,740	$10	$393.7K

Showing 1–10 of 116

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

Galen Medical Group, PC — 8 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

116 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	13	100	400	$60	$524.7K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	283	360	350	$50	$414.4K
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.	89	100	670	$60	$342.9K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	8	80	330	$170	$342.3K
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…	35	40	200	$20	$234.7K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	119	150	390	$60	$220.9K
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.	55	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…	136	3,760	610	$40	$202.3K
0241U	N/A	38	70	870	$90	$197.2K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	9	70	130	$140	$193.9K

Showing 1–10 of 116

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Doloris Hawk	TN	Family Nurse Practitioner	$1.1M	$0
Corinne Hinson	TN	Family Nurse Practitioner	$492.9K	$0
Chirag Patel	TN	Hepatology Physician	$398.5K	$3.1K
Asma Khan	TN	Endocrinology, Diabetes & Metabolism Physician	$175.8K	$77.3K
Ivey Williamson	TN	Internal Medicine Physician	$200.6K	$0
Ronald Jarl	TN	Family Medicine Physician	$190K	$0
Sachin Phade	TN	Vascular Surgery Physician	$188.5K	$1K
Nichon Grupka	NC	Anatomic Pathology & Clinical Pathology Physician	$183.4K	$0
Munford Yates	TN	Gastroenterology Physician	$170.7K	$0
Julie Bilbrey	TN	Family Medicine Physician	$166.2K	$290

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Agilitas Usa Inc	TN	Physical Therapy Clinic/Center	$0	$7.4M
Dental Center, Inc	TN	Dentist	$0	$7.4M
Lighthouse Kids Hixson, LLC	TN	Behavior Analyst	$0	$3.7M
Devon Ghodasra	TN	Retina Specialist (Ophthalmology) Physician	$3.6M	$0
Hixson Pediatric Dentistry PLLC	TN	Pediatric Dentistry	$0	$3.2M
Rohan Shah	TN	Retina Specialist (Ophthalmology) Physician	$2.9M	$0
Memorial Health Care System Inc.	TN	General Acute Care Hospital	$0	$2.4M
Chattanooga Pain Management Center LLC	TN	Ambulatory Surgical Clinic/Center	$2.4M	$1.6K
Francis Decroos	TN	Retina Specialist (Ophthalmology) Physician	$2.3M	$0
Chelsea Schwind	TN	Dentist	$0	$2.2M

Galen Medical Group, PC — Billing Profile & Reimbursement Data

Sign up for Galen Medical Group, PC — Billing Profile & Reimbursement Data policy alerts

Galen Medical Group, PC — Billing Profile & Reimbursement Data

Sign up for Galen Medical Group, PC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References