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.

Covenant Medical Group, Inc. (NPI 1457302010)

Covenant Medical Group, Inc. is a family medicine physician provider located in Knoxville, Tennessee. This profile covers 0 Medicare and 188 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	Covenant Medical Group, Inc.
Address	1420 Centerpoint Blvd
City	Knoxville
State	TN
ZIP	37932
Taxonomy	Family Medicine Physician
NPI Enumerated	May 16, 2006

Payer Source	Total Paid
Medicaid	$17.9M
Medicare	$0

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

188 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	214,660	$40	$8.2M
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…	136,520	$30	$4.5M
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…	11,770	$70	$823.8K
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…	13,040	$40	$456.4K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	5,480	$70	$394.6K
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.	3,160	$100	$303.2K
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…	4,950	$50	$247.3K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	7,700	$30	$230.8K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	5,180	$40	$207.3K
95886	The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more…	2,710	$70	$200.3K

Showing 1–10 of 188

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

Covenant Medical Group, Inc. — 9 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

188 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	34	80	100	$1,260	$405.3K
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	10	40	200	$20	$234.7K
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.	15	170	340	$190	$206.8K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	108	610	1,220	$40	$206K
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…	8	3,760	610	$40	$202.3K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	173	520	470	$70	$187K
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…	23	4,050	620	$30	$183.9K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	227	480	580	$60	$174.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	112	510	240	$70	$133.7K
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…	11	240	510	$50	$125.9K

Showing 1–10 of 188

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Covenant Medical Group	TX	Family Medicine Physician	$0	$34.3M
Advanced Diagnostic Imaging, PC	TN	Internal Medicine Physician	$0	$29.9M
Ryan Grover	TN	Radiation Oncology Physician	$2.2M	$0
Pamela Smith	KY	Hematology & Oncology Physician	$1.8M	$0
Sivalingam Kanagasegar	TN	Rheumatology Physician	$1.5M	$46.5K
Brion Shin	TN	Radiation Oncology Physician	$1.5M	$0
Allen Meek	TN	Radiation Oncology Physician	$1.4M	$0
Leslie Yonemoto	OK	Radiation Oncology Physician	$1.4M	$0
Feras Abdul Khalek	TN	Hematology & Oncology Physician	$470.8K	$820
Andrew Horowitz	TN	Urology Physician	$309.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Maxim Healthcare Services, Inc	TN	Home Health Agency	$0	$16.4M
Cde Onsite Senior Services Corporation	TN	In Home Supportive Care Agency	$0	$7.9M
Ross Kerns	TN	Hematology & Oncology Physician	$4.5M	$0
Daniel Ibach	TN	Hematology & Oncology Physician	$4.3M	$0
Integrity Laboratories, LLC	TN	Clinical Medical Laboratory	$109.6K	$4.1M
Parkwest Surgery Center LLC	TN	Ambulatory Surgical Clinic/Center	$1.9M	$0
Jeffrey Dell	TN	Gynecology Physician	$438.3K	$0
Contract Health Services, Inc.	TN	Sonography Specialist/Technologist Cardiovascular	$64.1K	$260.1K
Joseph Meyer	TN	Radiation Oncology Physician	$285.1K	$0
Jake Mcmillin	TN	Ophthalmology Physician	$212.1K	$0

Covenant Medical Group, Inc. — Billing Profile & Reimbursement Data

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Covenant Medical Group, Inc. — 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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