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

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

T J Samson Community Hospital (NPI 1477609865)

T J Samson Community Hospital is a family medicine physician provider located in Glasgow, Kentucky. This profile covers 0 Medicare and 179 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	T J Samson Community Hospital
Address	310 N L Rogers Wells Blvd
City	Glasgow
State	KY
ZIP	42141
Taxonomy	Family Medicine Physician
NPI Enumerated	January 26, 2007

Payer Source	Total Paid
Medicaid	$15.5M
Medicare	$0

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

179 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…	170,040	$40	$7M
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…	101,040	$30	$3M
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…	7,250	$70	$522.3K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	21,490	$20	$451.4K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	57,930	$10	$347.6K
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…	9,920	$30	$327.5K
59410	In this global service, the provider admits the patient to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal…	440	$700	$306.5K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	3,970	$50	$206.2K
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…	4,610	$40	$198.2K
95806	A technologist is not in attendance during this sleep study, which involves measuring several parameters while the patient sleeps in a clinic or sleep lab to help diagnose sleep disorders.	2,090	$90	$196.7K

Showing 1–10 of 179

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

T J Samson Community Hospital — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

179 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	31	30	43,760	$80	$5.2M
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.	81	180	1,870	$280	$1.5M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	75	80	7,740	$30	$1.1M
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.	125	170	2,610	$250	$1M
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.	93	180	2,960	$110	$672.4K
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…	18	210	1,340	$160	$568K
93458	In this procedure, the provider performs imaging supervision and interpretation for a coronary angiography with left heart catheterization and intraprocedural injections for left ventriculography. He…	46	60	170	$780	$500.2K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	40	100	440	$320	$477.2K
78815	PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.…	35	40	300	$640	$462.7K
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.	121	170	1,300	$230	$441K

Showing 1–10 of 179

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
T J Samson Community Hospital	KY	General Acute Care Hospital	$0	$95.7M
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Mark Risen	KY	Primary Podiatric Medicine Podiatrist	$170K	$444.7K
Matthew Hrastich	MO	Diagnostic Radiology Physician	$134.1K	$399.7K
Kalpesh Patel	AZ	Diagnostic Radiology Physician	$409.1K	$0
Mazen Sabbaq	MI	Pulmonary Disease Physician	$371.9K	$0
Aijaz Yazdani	KY	Pulmonary Disease Physician	$79.8K	$268K
Jennifer Shuemaker	KY	Nephrology Physician	$260.1K	$44.3K
Matthew Rutter	KY	Urology Physician	$287.4K	$0
Barret Lessenberry	KY	Orthopaedic Surgery Physician	$111.9K	$172.7K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Golden Gate Bridges	KY	Community/Behavioral Health Agency	$0	$17.6M
Oaks Behavioral Health PLLC	KY	Psychiatric/Mental Health Nurse Practitioner	$0	$14.9M
Alliance Counseling Associates	KY	Mental Health Counselor	$0	$12M
Ambulance Service Corporation Inc	KY	Ambulance	$1.2M	$3.4M
Adult Day Health, Inc.	KY	Adult Day Care Clinic/Center	$0	$3.4M
Martha Seeley, LLC	KY	Family Medicine Physician	$0	$2.9M
Mcpeak Surgery Center LLC	KY	Ambulatory Surgical Clinic/Center	$632.4K	$1.6M
Ely Drugs Inc	KY	Community/Retail Pharmacy	$74.8K	$729.2K
Martha Seeley	KY	Family Medicine Physician	$24.7K	$777.3K
Spencer Witcher	KY	Ophthalmology Physician	$487.4K	$50.3K

T J Samson 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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