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.

Ut Methodist Physicians LLC (NPI 1427317908)

Ut Methodist Physicians LLC is a internal medicine physician provider located in Memphis, Tennessee. This profile covers 0 Medicare and 63 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	Ut Methodist Physicians LLC
Address	1325 Eastmoreland Ave Ste 310
City	Memphis
State	TN
ZIP	38104
Taxonomy	Internal Medicine Physician
NPI Enumerated	May 3, 2012

Payer Source	Total Paid
Medicaid	$2.7M
Medicare	$0

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

63 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…	23,270	$30	$791.1K
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…	20,710	$20	$497K
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…	20,660	$20	$495.8K
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…	15,480	$20	$278.6K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	4,050	$30	$125.5K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	2,280	$20	$54.8K
99203	The provider sees a new 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 provider…	1,300	$30	$41.5K
95951	N/A	400	$100	$39.2K
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…	970	$40	$38.6K
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…	740	$50	$36.9K

Showing 1–10 of 63

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

Ut Methodist Physicians LLC — 7 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

63 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	356	360	350	$50	$414.4K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	321	440	530	$70	$282.3K
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.	64	170	340	$190	$206.8K
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…	154	3,760	610	$40	$202.3K
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…	262	4,050	620	$30	$183.9K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	48	80	70	$200	$121.4K
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…	74	160	110	$90	$96K
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…	258	1,080	120	$80	$90.7K
95720	A physician or other QHCP reviews recorded events and analyzes spike and seizure detection of a continuous electroencephalography, a study of the electrical activity of the brain. A video is…	8	20	100	$160	$82.5K
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…	14	550	290	$30	$77K

Showing 1–10 of 63

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Methodist Healthcare - Memphis Hospitals	TN	General Acute Care Hospital	$0	$105.6M
Methodist Healthcare - Memphis Hospitals	TN	Children's Hospital	$0	$84.4M
Ut Lebonheur Pediatric Specialists, Inc.	TN	Pediatrics Physician	$0	$63.8M
Ut Regional One Physicians Inc	TN	Surgery Physician	$0	$24.1M
Primary Care Group LLC	TN	Family Medicine Physician	$0	$23.5M
Methodist Healthcare - Olive Branch Hospital	MS	General Acute Care Hospital	$0	$18.1M
Alliance Health Services Inc.	TN	Durable Medical Equipment & Medical Supplies	$0	$11.2M
Methodist Inpatient Physicians LLC	TN	Internal Medicine Physician	$0	$4.8M
Lebonheur Patient Transportation	TN	Land Ambulance	$0	$4.5M
Specialty Physician Group LLC	TN	Cardiovascular Disease Physician	$0	$3.3M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Well Child Inc.	TN	Nurse Practitioner	$0	$19.8M
Bhg Reference Lab, LLC	TN	Clinical Medical Laboratory	$0	$14M
Wci School Health Services, PLLC	TN	Family Nurse Practitioner	$0	$10.4M
Memphis Radiological, P.C.	TN	Diagnostic Radiology Physician	$0	$9.1M
Memphis Medical Center Air Ambulance Service, Inc.	TN	Air Ambulance	$0	$6.5M
Southern College Of Optometry	TN	Optometrist	$0	$5.4M
Satellite Healthcare Of Poplar Avenue LLC	TN	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$5.2M
Phillip R. Bowden, M.d.,p.a.	TN	Gastroenterology Physician	$0	$4.6M
Memphis Recovery Centers, Inc.	TN	Substance Abuse Rehabilitation Facility	$0	$4.6M
Bianca Sweeten	TN	Pediatrics Physician	$0	$3.2M

Ut Methodist Physicians LLC — 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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