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.

Roane County Medical Center (NPI 1700036696)

Roane County Medical Center is a general acute care hospital provider located in Harriman, Tennessee. This profile covers 0 Medicare and 62 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	Roane County Medical Center
Address	8045 Roane Medical Center Dr
City	Harriman
State	TN
ZIP	37748
Taxonomy	General Acute Care Hospital
NPI Enumerated	September 26, 2008

Payer Source	Total Paid
Medicaid	$9.2M
Medicare	$0

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

62 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.	13,810	$240	$3.2M
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.	18,840	$170	$3.1M
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.	4,750	$320	$1.5M
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.	6,360	$90	$591.3K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	7,030	$20	$154.7K
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,…	5,410	$20	$119K
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…	19,510	$1	$78K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	6,040	$10	$48.3K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	13,060	$1	$39.2K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	13,000	$1	$39K

Showing 1–10 of 62

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

Roane County Medical Center — 0 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

62 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	84	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.	63	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.	90	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…	92	100	400	$60	$524.7K
G0378	Hospital observation service, per hour	87	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.	139	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.	22	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.	46	120	3,760	$30	$225K
U0004	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…	26	30	130	$50	$221.4K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	266	350	1,060	$30	$173.8K

Showing 1–10 of 62

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Larry Justice	TN	Cardiovascular Disease Physician	$201.8K	$0
Milan Sheth	TN	Interventional Cardiology Physician	$142K	$0
Hitesh Mehta	TN	Clinical Cardiac Electrophysiology Physician	$76K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Roane County Government	TN	Land Ambulance	$594.7K	$1.8M
Eye Care Centers PLLC	TN	Ophthalmology Physician	$0	$2.2M
Thomas Browning	TN	Retina Specialist (Ophthalmology) Physician	$412.6K	$0
Amanda Johnson	TN	Pediatric Nurse Practitioner	$176.8K	$0
Mark Hellmann	TN	Foot & Ankle Surgery Podiatrist	$93.8K	$78.4K
Mancel Wakham	TN	Family Medicine Physician	$69.8K	$77.7K
Silvia Mende	TN	Optometrist	$76.8K	$52K
Conway Ella	TN	Certified Registered Nurse Anesthetist	$44.8K	$0
Ann Bacher	TN	Psychiatric/Mental Health Nurse Practitioner	$30.1K	$0

Roane County Medical Center — Billing Profile & Reimbursement Data

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Roane County Medical Center — 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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