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.

Blue Ridge Medical Managgement Corporation (NPI 1649518309)

Blue Ridge Medical Managgement Corporation is a internal medicine physician provider located in Kingsport, Tennessee. This profile covers 0 Medicare and 23 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	Blue Ridge Medical Managgement Corporation
Address	4600 Fort Henry Dr
City	Kingsport
State	TN
ZIP	37663
Taxonomy	Internal Medicine Physician
NPI Enumerated	January 30, 2013

Payer Source	Total Paid
Medicaid	$2.2M
Medicare	$0

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

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	21,880	$40	$897.1K
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…	9,990	$50	$539.4K
0241U	N/A	3,110	$100	$317.4K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	4,250	$30	$118.9K
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…	2,690	$40	$107.5K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	1,020	$80	$80.7K
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,…	1,070	$30	$34.2K
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.	3,660	$10	$29.3K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	3,710	$10	$25.9K
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…	410	$50	$20.6K

Showing 1–10 of 23

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

Blue Ridge Medical Managgement Corporation — 1 of 16 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

23 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	325	3,760	610	$40	$202.3K
0241U	N/A	16	70	870	$90	$197.2K
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…	198	4,050	620	$30	$183.9K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	61	200	300	$60	$106K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	32	200	380	$30	$80.6K
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…	63	380	270	$40	$78.3K
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…	379	1,240	120	$60	$53.1K
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.	146	1,050	340	$10	$33.9K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	126	1,000	350	$10	$23.9K
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,…	229	1,170	170	$20	$23.8K

Showing 1–10 of 23

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wellmont Medical Associates Inc	TN	Pulmonary Disease Physician	$0	$27.8M
Wellmont Medical Associates Inc	VA	Family Medicine Physician	$0	$24.6M
Takoma Regional Hospital Inc	TN	General Acute Care Hospital	$0	$20.1M
Blue Ridge Medical Management Corporation	TN	Family Nurse Practitioner	$0	$8M
Wellmont Cardiology Services	TN	Cardiovascular Disease Physician	$0	$3.1M
Blue Ridge Medical Management Corporation	TN	Pediatrics Physician	$0	$2.9M
Blue Ridge Medical Management Corporation	TN	Internal Medicine Physician	$0	$2.8M
Sos Nalghranyan	FL	Hematology & Oncology Physician	$1.1M	$0
Harsha Vardhana	TN	Medical Oncology Physician	$941.1K	$66.6K
Martin Palmeri	NC	Hematology & Oncology Physician	$931.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Resp-i-care, Inc.	TN	Oxygen Equipment & Supplies (DME)	$0	$6.4M
Warren Jones	TN	Family Medicine Physician	$132.5K	$0
Priscilla Henry	TN	Family Nurse Practitioner	$41.1K	$0
Gary Wilson	TN	Anesthesiology Physician	$11.5K	$0
Katherine Nehemy	TN	Certified Registered Nurse Anesthetist	$9.7K	$0

Blue Ridge Medical Managgement Corporation — Billing Profile & Reimbursement Data

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Blue Ridge Medical Managgement Corporation — 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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