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 Virginia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Virginia 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. Virginia (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.

Carilion Tazewell Community Hospital (NPI 1427040328)

Carilion Tazewell Community Hospital is a general acute care hospital provider located in Tazewell, Virginia. This profile covers 0 Medicare and 121 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	Carilion Tazewell Community Hospital
Address	388 Ben Bolt Ave
City	Tazewell
State	VA
ZIP	24651
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 17, 2005

Payer Source	Total Paid
Medicaid	$8M
Medicare	$0

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

121 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	10,360	$150	$1.6M
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.	9,000	$150	$1.4M
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.	6,090	$160	$991.9K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	3,660	$230	$856.4K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	3,460	$130	$459.5K
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.	3,420	$130	$458.5K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	2,350	$180	$428.1K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	6,380	$60	$357.3K
0241U	N/A	4,570	$60	$265.2K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	1,440	$140	$206.9K

Showing 1–10 of 121

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Virginia providers billing the same CPT/HCPCS codes.

Claims Volume vs. Virginia Distribution

Carilion Tazewell Community Hospital — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

121 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	66	90	9,030	$280	$3.2M
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.	101	340	160	$130	$1.3M
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.	103	630	90	$140	$1.1M
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.	66	140	3,240	$160	$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.	113	620	70	$120	$1M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	101	180	2,950	$140	$783.2K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	87	170	3,390	$100	$658.8K
96366	The provider administers an intravenous infusion or infusions of a medication for an additional hour or subsequent hours after the first hour to prevent, treat, or diagnose a condition or disease.	56	80	1,510	$220	$512K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	63	110	2,780	$110	$471.1K
96360	The provider introduces a catheter intravenously for supplementation of fluid and electrolytes for 31 minutes to one hour to treat severe cases of dehydration.	73	90	2,670	$130	$444.4K

Showing 1–10 of 121

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Carilion Medical Center	VA	Multi-Specialty Clinic/Center	$0	$73.4M
Carilion Healthcare Corporation	VA	Multi-Specialty Clinic/Center	$0	$26.1M
Carilion Medical Center	VA	Emergency Medicine Physician	$0	$18.1M
Shaya Ansari	NY	Diagnostic Radiology Physician	$1.5M	$1K
Jeffery Shay	GU	Vascular & Interventional Radiology Physician	$987.8K	$0
Mrunal Tailor	NM	Diagnostic Radiology Physician	$897.5K	$0
Matthew Herczyk	VA	Diagnostic Radiology Physician	$750.5K	$47.4K
Saint Lukes Physician Group Inc	KS	Nurse Practitioner	$0	$586.4K
Syed Akbar	IL	Diagnostic Radiology Physician	$280.8K	$223.7K
Edmund Harris	NJ	Diagnostic Radiology Physician	$421.5K	$65.4K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vijay Ramakrishnan	VA	Diagnostic Radiology Physician	$153.3K	$4.3K
William Shrader	VA	Family Medicine Physician	$131.4K	$820
Denny Goss	VA	Emergency Medicine Physician	$91.8K	$0
Karen Hart	VA	Family Nurse Practitioner	$68.7K	$0

Carilion Tazewell Community Hospital — Billing Profile & Reimbursement Data

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Carilion Tazewell Community Hospital — 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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