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.

Baptist Memorial Hospital (NPI 1578527172)

Key Findings

Field	Value
Entity Type	Organization
Organization	Baptist Memorial Hospital
Address	6019 Walnut Grove Rd
City	Memphis
State	TN
ZIP	38120
Taxonomy	General Acute Care Hospital
NPI Enumerated	April 12, 2006

Payer Source	Total Paid
Medicaid	$51.4M
Medicare	$0

This provider has no Medicare billing on file and reports $51.4M in lifetime Medicaid revenue, making its observable payer footprint effectively single-payer Medicaid. The NPI was enumerated 2006-04-12 (~20 years ago), indicating an established facility with a long operating history in the market.

Medicaid revenue is highly concentrated in emergency department E/M services: the top three Medicaid codes 99284, 99283, and 99285 together account for 68.9% of the provider's total Medicaid revenue. Individually these codes generate $14.2M (29.2%) from 99284, $10.9M (22.3%) from 99283, and $8.4M (17.3%) from 99285, signaling ED visits are the primary revenue drivers.

The code mix and volumes point to a heavy ED and acute outpatient operations model. High claim counts for 99284 (87.9K claims), 99283 (93.7K claims), and 99285 (40.7K claims) indicate sustained emergency throughput across low, moderate, and high complexity presentations, and presence of observation billing (G0378, $579.1K) supports an ED-to-observation care pathway.

Competitively, the provider is a statewide leader for several ED and related codes: 99283 ranks #10 of 611 providers in-state (99th percentile, labeled an "extreme outlier"), 99284 ranks #15 of 625 (98th percentile, "notably above typical"), and 99285 ranks #15 of 565 (98th percentile, described as typical/unremarkable volume for that code). Additional ED low-acuity codes such as 99282 (28.1K claims, $2M; rank #3 of 184, 99th percentile, "extreme outlier") further underline dominant state-level ED volumes.

Laboratory and infectious disease testing volumes are another distinguishing feature: U0002 (39.3K claims, $1.7M) ranks #1 of 75 providers in-state (100th percentile, "extreme outlier"), C9803 (54.5K claims, $709.1K) ranks #1 of 30 (100th percentile), and 87804 (113.6K claims, $908.9K) ranks #3 of 1047 (100th percentile). These figures indicate unusually large specimen collection and respiratory/COVID testing throughput relative to peers.

Infusion and procedural outpatient services provide meaningful, secondary Medicaid revenue streams. High-volume administration codes such as 96374 (32.8K claims, $1.4M; rank #2 of 121, 99th percentile) and 96375 (20.8K claims, $374K; rank #2 of 126, 99th percentile), together with procedural revenue from 43239 (2.9K claims, $1.4M) and imaging/echo codes like 93306 (21.1K claims, $505.7K), show diversified ancillary services tied to the ED and outpatient throughput.

The provider’s revenue profile shows concentration risk because a large majority of Medicaid dollars come from a small set of ED codes (the top three codes alone are 68.9% of Medicaid revenue). That concentration means shifts in emergency service utilization, Medicaid ED policy, or reimbursement for these specific codes could materially affect total Medicaid revenue.

Taken together—long tenure (~20 years), very high state-percentile ranks across multiple codes, and multiple #1 rankings for testing and collection codes—this hospital functions as a major statewide hub for emergency care and high-throughput outpatient testing. Analysts should treat it as a dominant in-state ED and testing center with substantial Medicaid exposure concentrated in acute care visit lines.

Medicaid: Complete Services Breakdown

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

169 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.	87,850	$160	$14.2M
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.	93,690	$120	$10.9M
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.	40,740	$210	$8.4M
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.	28,090	$70	$2M
U0002	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	39,350	$40	$1.7M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	32,790	$40	$1.4M
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.	2,880	$480	$1.4M
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…	21,370	$50	$983K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	113,610	$10	$908.9K
C9803	Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	54,550	$10	$709.1K

Showing 1–10 of 169

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

Baptist Memorial Hospital — 18 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

169 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	30	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.	15	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.	10	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.	15	570	640	$100	$637.8K
92586	N/A	3	10	370	$40	$555K
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…	43	100	400	$60	$524.7K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	56	60	320	$140	$346.9K
43775	Using laparoscopic technique, the provider reduces the size of the stomach by removing the bulk of the stomach in a vertical fashion. This procedure leaves a long, cylindrical stomach without the…	3	10	80	$960	$314K
92650	In this procedure, the provider measures the patient’s response to sound stimuli to screen auditory potential (electrical response). The screening uses frequency nonspecific stimuli and automated…	2	10	30	$20	$300.7K
G0378	Hospital observation service, per hour	7	100	410	$210	$264K

Showing 1–10 of 169

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Steven Gubin	TN	Cardiovascular Disease Physician	$936.6K	$0
Todd Edwards	TN	Cardiovascular Disease Physician	$837.5K	$0
David Lan	TN	Clinical Cardiac Electrophysiology Physician	$614.4K	$0
Homayoun Ahmadian	TN	Cardiovascular Disease Physician	$390.8K	$0
Oran Berkenstock	TN	Hospitalist Physician	$258K	$8.9K
Tamunoinemi Bob-manuel	TN	Interventional Cardiology Physician	$214.7K	$0
Phillip Zeni	TN	Vascular & Interventional Radiology Physician	$208.5K	$0
Ellis Reef	TN	Cardiovascular Disease Physician	$189.8K	$3.8K
Mahir Awdeh	TN	Cardiovascular Disease Physician	$51.5K	$77.5K
Dmitry Yaranov	TN	Advanced Heart Failure and Transplant Cardiology Physician	$116.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
East Memphis Neonatology Associates P.C	TN	Neonatal-Perinatal Medicine Physician	$0	$20.7M
Semmes-murphey Clinic PC	TN	Ambulatory Surgical Clinic/Center	$4.1M	$11K
Lebonheur East Surgery Center Ii LP	TN	Ambulatory Surgical Clinic/Center	$0	$3M
Ridge Lake Asc, LLC	TN	Ophthalmologic Surgery Clinic/Center	$2.4M	$390.5K
Vrf Eye Specialty Group, Plc	TN	Ophthalmology Physician	$0	$2.5M
Gastrointestinal Specialists Foundation, Inc	TN	Gastroenterology Physician	$0	$2.5M
George Woodman	TN	Surgery Physician	$1.1K	$2.3M
Otolaryngology Consultants Of Memphis, P.C.	TN	Specialist	$0	$2.1M
Obgyn Consultants Of Memphis	TN	Obstetrics & Gynecology Physician	$0	$2.1M
Mays & Schnapp Pain Clinic & Rehabilitation Center	TN	Ambulatory Surgical Clinic/Center	$1.5M	$0

Baptist Memorial Hospital — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References