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.

Emergency Physicians At Sumner PLLC (NPI 1538149521)

Field	Value
Entity Type	Organization
Organization	Emergency Physicians At Sumner PLLC
Address	555 Hartsville Pike
City	Gallatin
State	TN
ZIP	37066
Taxonomy	Emergency Medical Services (Emergency Medicine) Physician
NPI Enumerated	January 18, 2006

Payer Source	Total Paid
Medicaid	$3.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

4 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.	33,870	$50	$1.8M
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.	20,960	$60	$1.2M
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.	12,430	$40	$447.4K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	9,380	$1	$28.1K

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

Emergency Physicians At Sumner PLLC — 1 of 4 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

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	41	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.	88	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.	29	570	640	$100	$637.8K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	43	410	400	$1	$22.1K

Nearby Providers

Other providers in the same ZIP code as Emergency Physicians At Sumner PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Group Effort Of Tennessee, LLC.	TN	Developmental Disabilities Clinic/Center	$0	$31.4M
Vip Midsouth, LLC	TN	Pediatrics Physician	$0	$30.4M
Sumner Regional Medical Center LLC	TN	General Acute Care Hospital	$0	$11.8M
21st Century Rehabilitation Services	TN	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$9.5M
County Of Sumner	TN	Land Ambulance	$1.6M	$4.5M
Trinity Pediatrics, P.C.	TN	Pediatrics Physician	$0	$5.8M
Children's Dentistry Of Gallatin	TN	Pediatric Dentistry	$0	$5.4M
Tamjeed Ahmed	TN	Hematology & Oncology Physician	$913.2K	$0
Dianna Shipley	TN	Medical Oncology Physician	$636.7K	$0
Anne Hensley	TN	Nurse Practitioner	$410.9K	$0

Emergency Physicians At Sumner PLLC — Billing Profile & Reimbursement Data

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Emergency Physicians At Sumner PLLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References