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.

Prudent Health Services Inc. (NPI 1598927022)

Field	Value
Entity Type	Organization
Organization	Prudent Health Services Inc.
Address	845 Bell Rd Ste 223
City	Antioch
State	TN
ZIP	37013
Taxonomy	Home Health Agency
NPI Enumerated	June 26, 2008

Payer Source	Total Paid
Medicaid	$3.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5125	Attendant care services; per 15 minutes	20,500	$110	$2.2M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	13,190	$60	$844.2K
S5150	Unskilled respite care, not hospice; per 15 minutes	1,040	$130	$138.9K

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

Prudent Health Services Inc. — 0 of 3 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

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5125	Attendant care services; per 15 minutes	71	160	18,880	$110	$3.9M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	94	210	10,880	$90	$3.7M
S5150	Unskilled respite care, not hospice; per 15 minutes	59	110	1,370	$60	$264K

Nearby Providers

Other providers in the same ZIP code as Prudent Health Services Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Metropolitan Government Of Nashville & Davidson County	TN	Ambulance	$3.4M	$32M
Urgent Care Enterprise LLC	TN	Urgent Care Clinic/Center	$0	$11.6M
Mighty Hearts Home Care Inc	TN	In Home Supportive Care Agency	$0	$7.6M
Tennessee Pain Surgery Center, LLC	TN	Ambulatory Surgical Clinic/Center	$669.9K	$4.5M
Pain Management Group, P.C.	TN	Interventional Pain Medicine Physician	$0	$4.2M
Eyecare Plus Hh, PLLC	TN	Optometrist	$0	$3.5M
Savina Kimbrough	TN	Family Nurse Practitioner	$94.6K	$0
John Welker	TN	Interventional Pain Medicine Physician	$77.3K	$0
John Culclasure	TN	Pain Medicine (Anesthesiology) Physician	$24.2K	$0

Prudent Health Services Inc. — Billing Profile & Reimbursement Data

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Prudent Health Services 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

Nearby Providers

Frequently Asked Questions

References