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.

Express Med Of Tennessee, LLC (NPI 1679534879)

Express Med Of Tennessee, LLC is a rural health clinic/center provider located in Lawrenceburg, Tennessee. This profile covers 0 Medicare and 56 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	Express Med Of Tennessee, LLC
Address	726 N Locust Ave
City	Lawrenceburg
State	TN
ZIP	38464
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	March 29, 2006

Payer Source	Total Paid
Medicaid	$2.6M
Medicare	$0

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

56 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…	40,030	$30	$1.1M
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…	27,530	$30	$826K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	14,470	$10	$173.7K
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.	10,800	$10	$86.4K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	2,850	$30	$76.9K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	570	$120	$66.2K
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.	5,250	$10	$42K
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…	490	$50	$24.9K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	370	$50	$20.2K
95117	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives 2 or more injections at a single visit.	3,410	$10	$17.1K

Showing 1–10 of 56

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

Express Med Of Tennessee, LLC — 4 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

56 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	32	80	330	$170	$342.3K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	300	440	530	$70	$282.3K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	586	610	1,220	$40	$206K
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…	111	3,760	610	$40	$202.3K
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…	109	4,050	620	$30	$183.9K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	66	130	370	$50	$183.3K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	251	310	110	$70	$142.8K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	230	240	510	$50	$125.9K
95117	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives 2 or more injections at a single visit.	31	110	650	$10	$105.4K
99204	The provider sees a new 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 provider…	662	1,080	120	$80	$90.7K

Showing 1–10 of 56

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shelby Hooper	TN	Acute Care Nurse Practitioner	$70.4K	$0
NPI 1295739902	—	—	$29.3K	$0
Julie Archer	AL	Family Nurse Practitioner	$22.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Emergency Coverage Services, PC	TN	Nurse Practitioner	$0	$11.5M
One Stop Medical, LLC	TN	Rural Health Clinic/Center	$0	$10.3M
Amg-crockett, LLC	TN	Family Medicine Physician	$0	$4.8M
Crockett Hospital LLC	TN	Rural Acute Care Hospital	$0	$4.6M
The Speech Language & Learning Center LLC	TN	Occupational Therapist	$0	$3.5M
County Of Lawrence	TN	Land Ambulance	$704K	$1.8M
Speech Language & Learning Center Of Tn	TN	Speech-Language Pathologist	$0	$2.4M
Robert Chen	TN	Dermatology Physician	$544.5K	$103.3K
Air Evac Ems Inc	TN	Air Ambulance	$566.1K	$49.5K
Haley Kimbrell	TN	Family Nurse Practitioner	$247.7K	$0

Express Med Of Tennessee, LLC — Billing Profile & Reimbursement Data

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Express Med Of Tennessee, LLC — 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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