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.

App Of Tennessee Hm, PLLC (NPI 1396160768)

App Of Tennessee Hm, PLLC is a hospitalist physician provider located in Shelbyville, Tennessee. This profile covers 0 Medicare and 15 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	App Of Tennessee Hm, PLLC
Address	2835 Highway 231 N
City	Shelbyville
State	TN
ZIP	37160
Taxonomy	Hospitalist Physician
NPI Enumerated	February 21, 2014

Payer Source	Total Paid
Medicaid	$2.8M
Medicare	$0

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	72,310	$10	$940K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	79,820	$10	$798.2K
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…	14,370	$30	$445.3K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	7,680	$40	$276.6K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	16,610	$20	$249.2K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	2,740	$20	$57.5K
99220	N/A	1,850	$20	$44.3K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	2,890	$10	$28.9K
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	160	$20	$2.4K
99219	N/A	170	$10	$2.4K

Showing 1–10 of 15

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

App Of Tennessee Hm, PLLC — 6 of 15 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

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	7	160	110	$90	$96K
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…	3	550	290	$30	$77K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	4	840	440	$20	$73K
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…	6	480	160	$50	$46.3K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	23	310	160	$40	$37.9K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	158	260	280	$20	$35.4K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	4	280	110	$30	$29K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	23	350	110	$40	$25.4K
99220	N/A	2	110	80	$50	$12.3K
99219	N/A	11	50	70	$70	$12.3K

Showing 1–10 of 15

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jeffrey Summers	TN	Internal Medicine Physician	$624.1K	$0
Sriram Krishnasamy	TN	Pulmonary Disease Physician	$134.5K	$3.9K
Susannah Johnson	NC	Internal Medicine Physician	$116K	$0
Matthew Joseph	TN	Hospitalist Physician	$108.9K	$0
Jack Carey	TN	Internal Medicine Physician	$92.5K	$13K
William Bell	MS	Internal Medicine Physician	$96.7K	$0
Rebekah Sprouse	TN	Hospitalist Physician	$95.5K	$0
Michael Seibert	TN	Family Medicine Physician	$58.5K	$6.4K
Justin Tomal	ID	Gastroenterology Physician	$61.5K	$0
Michelle Holtgraewe	TN	Nurse Practitioner	$50.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vanderbilt Bedford Hospital, LLC	TN	General Acute Care Hospital	$0	$4.4M
Healthy Kids LLC	TN	Pediatrics Physician	$0	$4M
County Of Bedford Office Of County Executive	TN	Land Ambulance	$511.3K	$2M
Shelbyville Hospital Company LLC	TN	General Acute Care Hospital	$0	$2.5M
Ryan Carr	TN	Hematology & Oncology Physician	$1.5M	$0
Kenneth Hasty	TN	Optometrist	$60.2K	$1.4M
Joseph Rupard	TN	Family Medicine Physician	$112.3K	$602.4K
Nnamdi Eze	TN	Hematology & Oncology Physician	$678K	$0
Charles Kelly	TN	Gastroenterology Physician	$106.3K	$515.9K
Chris Marasco	TN	Internal Medicine Physician	$237.5K	$0

App Of Tennessee Hm, PLLC — 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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