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.

Southern Tennessee Medical Center LLC (NPI 1467408781)

Southern Tennessee Medical Center LLC is a general acute care hospital provider located in Winchester, Tennessee. This profile covers 0 Medicare and 106 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	Southern Tennessee Medical Center LLC
Address	185 Hospital Rd
City	Winchester
State	TN
ZIP	37398
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 26, 2006

Payer Source	Total Paid
Medicaid	$9.4M
Medicare	$0

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

106 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	29,790	$140	$4.3M
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.	24,950	$120	$3.1M
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.	6,870	$50	$309.2K
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.	1,290	$220	$285.3K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	4,700	$40	$206.9K
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…	1,240	$140	$177.9K
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…	4,690	$30	$159.4K
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…	3,610	$30	$122.8K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	25,100	$1	$100.4K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	22,240	$1	$66.7K

Showing 1–10 of 106

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

Southern Tennessee Medical Center LLC — 0 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

106 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	28	60	1,340	$50	$1.1M
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.	48	630	510	$120	$1.1M
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.	48	610	570	$110	$884.4K
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.	169	570	640	$100	$637.8K
G0481	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	39	70	180	$60	$589.9K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	40	100	400	$60	$524.7K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	54	70	160	$500	$421.5K
G0378	Hospital observation service, per hour	93	100	410	$210	$264K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	111	240	840	$20	$259.2K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	54	120	3,760	$30	$225K

Showing 1–10 of 106

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Amg-southern Tennessee LLC	TN	General Practice Physician	$0	$9.3M
New Life Tn	TN	In Home Supportive Care Agency	$0	$4.1M
Imhona Eko-isenalumhe	TN	Internal Medicine Physician	$127.1K	$1M
Med-trans Corporation	TN	Air Ambulance	$497.9K	$294K
Mircea Basaraba	TN	Cardiovascular Disease Physician	$488.2K	$0
Roderick Meese	TN	Cardiovascular Disease Physician	$258.1K	$2.8K
Jessica Stensby	TN	Internal Medicine Physician	$185.1K	$0
Anisa Nayeem	TN	Nephrology Physician	$137.9K	$1.7K
Michelle Bull	TN	Family Nurse Practitioner	$98.8K	$0
Heather Hyden	TN	Family Nurse Practitioner	$78K	$0

Southern Tennessee Medical Center LLC — Billing Profile & Reimbursement Data

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Southern Tennessee Medical Center 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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