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.

Matrix Medical Plus (NPI 1376973461)

Matrix Medical Plus is a nurse practitioner provider located in Nashville, Tennessee. This profile covers 0 Medicare and 67 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	Matrix Medical Plus
Address	424 Church St Ste 2600
City	Nashville
State	TN
ZIP	37219
Taxonomy	Nurse Practitioner
NPI Enumerated	November 26, 2013

Payer Source	Total Paid
Medicaid	$3.2M
Medicare	$0

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

67 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99600	Use 99600 to report a home visit service or procedure that does not have a specific code.	4,840	$370	$1.8M
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	1,190	$380	$447.5K
99345	The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends at least 75…	1,050	$340	$358.8K
99344	The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider spends at least…	1,080	$270	$294.8K
99403	At an encounter separate from a preventive medicine visit, the provider offers counseling related to subjects appropriate for the patient’s age, family history, and areas of concern. The subjects…	320	$320	$102.7K
99305	The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	220	$380	$81.8K
99318	Deleted code, effective Jan. 1, 2023	210	$290	$61.9K
99204	The provider sees a new 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 provider…	350	$100	$36.8K
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…	70	$10	$740
93925	The provider performs a duplex ultrasound scan of the lower extremity arteries or bypass grafts on both sides. Providers perform noninvasive arterial diagnostic procedures to examine the rate of…	130	$1	$250

Showing 1–10 of 67

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

Matrix Medical Plus — 1 of 11 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

67 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99600	Use 99600 to report a home visit service or procedure that does not have a specific code.	2	10	12,590	$150	$1.9M
99349	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	63	100	180	$70	$141.1K
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…	191	240	510	$50	$125.9K
99344	The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider spends at least…	4	40	40	$140	$94.5K
99204	The provider sees a new 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 provider…	343	1,080	120	$80	$90.7K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	124	360	500	$10	$51.1K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	129	220	320	$1	$35K
99345	The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends at least 75…	2	10	40	$100	$34.1K
99350	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves high medical decision making or the provider spends at least 60…	27	30	410	$20	$22K
99403	At an encounter separate from a preventive medicine visit, the provider offers counseling related to subjects appropriate for the patient’s age, family history, and areas of concern. The subjects…	2	10	80	$110	$21.5K

Showing 1–10 of 67

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Camelot Care Centers, LLC	TN	Community/Behavioral Health Agency	$0	$113.1M
Community Care Health Network LLC	TN	Nurse Practitioner	$0	$44.4M
Gastroenterology & Surgery Center Of Arkansas, Ii, LLC.	TN	Ambulatory Surgical Clinic/Center	$540K	$2.8M
Ultra Health LLC	TN	Geriatric Medicine (Internal Medicine) Physician	$0	$3.3M

Matrix Medical Plus — Billing Profile & Reimbursement Data

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Matrix Medical Plus — 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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