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.

University Health System, Inc. (NPI 1538164090)

University Health System, Inc. is a general acute care hospital provider located in Knoxville, Tennessee. This profile covers 0 Medicare and 202 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	University Health System, Inc.
Address	1924 Alcoa Hwy
City	Knoxville
State	TN
ZIP	37920
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 20, 2005

Payer Source	Total Paid
Medicaid	$13.8M
Medicare	$0

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

202 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.	47,800	$140	$6.6M
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.	17,700	$90	$1.6M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	13,670	$60	$806.6K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	11,300	$60	$644.1K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	6,390	$90	$568.8K
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…	105,950	$10	$529.7K
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.	10,430	$40	$417.4K
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…	7,990	$50	$415.4K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	5,390	$50	$290.8K
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.	900	$260	$233K

Showing 1–10 of 202

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

University Health System, Inc. — 5 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

202 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	20	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.	24	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.	69	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.	428	570	640	$100	$637.8K
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…	12	100	400	$60	$524.7K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	6	40	1,860	$70	$294.9K
G0378	Hospital observation service, per hour	63	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.	219	240	840	$20	$259.2K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	7	180	480	$90	$245.5K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	30	120	3,760	$30	$225K

Showing 1–10 of 202

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Health System, Inc	TN	Pediatrics Physician	$0	$16.8M
University Of Tennessee	TN	Dentist	$0	$3.1M
University Of Tennessee	TN	Multi-Specialty Clinic/Center	$0	$2.6M
Joseph Kelley	NC	Radiation Oncology Physician	$878.9K	$0
Scott Stevens	TN	Vascular Surgery Physician	$228.7K	$0
Brian Pratt	GA	Family Medicine Physician	$205.9K	$0
Steven Dill	TN	Radiation Oncology Physician	$184K	$0
Sarah Darbandi	FL	Ophthalmology Physician	$154.6K	$0
Mindy Hsiao	IN	Hematology & Oncology Physician	$153.1K	$0
Aimee Wehber	TN	Cardiovascular Disease Physician	$144.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
High Risk Obstetrical Consultants, PLLC	TN	Maternal & Fetal Medicine Physician	$0	$32.6M
Laboratory Corporation Of America	TN	Clinical Medical Laboratory	$5.2M	$19.8M
Regional Neonatal Associates	TN	Neonatal-Perinatal Medicine Physician	$0	$9.4M
Association Of University Radiologists, PC	TN	Diagnostic Radiology Physician	$0	$6M
Cherokee Farm Orthopedic Surgery Center, LLC	TN	Ambulatory Surgical Clinic/Center	$2.6M	$0
State Of Tennessee	TN	Clinical Medical Laboratory	$0	$2.4M
Pediatric Consultants Of East Tennessee	TN	Pediatrics Physician	$0	$2.1M
Lynellen Gregory	TN	Vascular Surgery Physician	$415.1K	$0
Paul Pruett	TN	Glaucoma Specialist (Ophthalmology) Physician	$410.4K	$0
Drew Miller	TN	MOHS-Micrographic Surgery Physician	$286K	$124.3K

University Health System, 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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