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.

Sweetwater Hospital Association (NPI 1366441370)

Sweetwater Hospital Association is a general acute care hospital provider located in Sweetwater, Tennessee. This profile covers 0 Medicare and 196 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	Sweetwater Hospital Association
Address	304 Wright St
City	Sweetwater
State	TN
ZIP	37874
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 20, 2005

Payer Source	Total Paid
Medicaid	$12.9M
Medicare	$0

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

196 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	20,770	$180	$3.8M
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.	20,810	$150	$3.2M
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.	12,700	$110	$1.4M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	44,220	$30	$1.1M
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.	1,710	$260	$451.7K
76376	In this procedure, the provider performs 3D rendering for computed tomography magnetic resonance imaging, ultrasound, or another tomographic modality, typically for diagnostic purposes, with…	14,060	$20	$295.2K
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…	26,880	$10	$241.9K
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…	54,530	$1	$218.1K
99281	The provider sees a patient for the lowest level emergency department visit.	2,810	$70	$185.6K
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.	1,110	$160	$175.9K

Showing 1–10 of 196

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

Sweetwater Hospital Association — 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

196 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	6	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.	61	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.	55	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.	190	570	640	$100	$637.8K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	60	70	160	$500	$421.5K
81220	The lab analyst performs the technical lab test to detect the presence of changes in the gene for cystic fibrosis transmembrane conductance regulator, also known as CFTR. The test evaluates the CFTR…	7	10	210	$200	$285.2K
G0378	Hospital observation service, per hour	55	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.	60	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.	9	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.	47	120	3,760	$30	$225K

Showing 1–10 of 196

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sweetwater Hospital Association	TN	Obstetrics & Gynecology Physician	$0	$2.4M
Laurence James	TN	Internal Medicine Physician	$95.1K	$83.6K
Abdelhamid Alsharif	TN	Pulmonary Disease Physician	$80.8K	$0
Carl Goins	TN	Physician Assistant	$50K	$0
Thomas Vance	TN	Family Nurse Practitioner	$22.4K	$0
Robert Cummings	TN	Physician Assistant	$22.3K	$0
Michelle Davis	TN	Nurse Practitioner	$20.2K	$0
Ivy Massengale	TN	Physician Assistant	$15.9K	$0
Gregory Mckinney	WY	Certified Registered Nurse Anesthetist	$3.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Med-trans Corporation	TN	Air Ambulance	$426.3K	$136.7K
David Norris	TN	Diagnostic Radiology Physician	$22.8K	$66.2K
Tina James	TN	Diagnostic Radiology Physician	$14.9K	$70.8K
Lynda Rogers	TN	Diagnostic Radiology Physician	$30.6K	$0

Sweetwater Hospital Association — Billing Profile & Reimbursement Data

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Sweetwater Hospital Association — 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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