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.

Hca Health Services Of Tennessee, Inc. (NPI 1720032345)

Key Findings

Field	Value
Entity Type	Organization
Organization	Hca Health Services Of Tennessee, Inc.
Address	391 Wallace Rd
City	Nashville
State	TN
ZIP	37211
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 19, 2006

Payer Source	Total Paid
Medicaid	$27.5M
Medicare	$0

This provider effectively operates as a Medicaid-focused facility: there is no Medicare billing on file and total Medicaid revenue on record is $27.5M, making Medicaid the sole payer source represented in these claims data. Analysts should treat this profile as single‑payer (Medicaid) when evaluating reimbursement exposure and payer mix risk.

Revenue is extremely concentrated in three codes: the top three Medicaid codes (99283, 99284, 96374) together account for 93.1% of the provider's Medicaid revenue. Those codes appear with the following reported contributions to revenue: 99283 — $14.7M (53.6%); 99284 — $9.6M (35.0%); 96374 — $1.2M (4.5%).

The code mix signals an emergency department–centric operation: the dominant revenue drivers are ED evaluation and management codes 99283 and 99284, and the third largest code 96374 is for IV push medication administration. This pattern is consistent with high ED throughput and frequent parenteral medication delivery as primary sources of billable activity rather than elective inpatient or high‑margin procedure lines.

Acuity appears weighted toward low-to-moderate ED complexity rather than high‑acuity care: 99283 and 99284 make up the majority of revenue while 99285 (high acuity) contributes only $50K (0.2% of Medicaid revenue) and 190 claims, suggesting relatively few high‑complexity ED encounters billed to Medicaid. This distribution may shape staffing, resource allocation, and downstream revenue opportunities tied to inpatient conversion.

Competitive standing in-state is strong for several of the top codes: 99283 ranks #20 of 611 providers in Tennessee (97th percentile) and is labeled "notably above typical state volume," while 96374 ranks #6 of 121 (96th percentile) and is also "notably above typical state volume." By contrast, 99284 ranks #34 of 625 (95th percentile) but is described as "typical, unremarkable volume," indicating a large absolute volume that nevertheless mirrors broader statewide practice patterns.

There are statistical outliers in testing and low‑unit services that warrant attention despite small revenue impact: 87502 shows 12.5K claims for $12.5K revenue and is flagged as an "extreme outlier, far above typical state volume," reflecting very high test volumes at a low unit price. Other COVID and PCR test codes (87635, U0003, U0002) appear with modest revenue shares, indicating diagnostic testing activity is present but not a primary revenue driver.

The provider has longstanding operational tenure: the NPI enumeration date is 2006-05-19 (~20 years ago), which supports use of multiyear credentialing, network participation history, and long‑running utilization patterns in comparative analyses. Historical presence may also inform assessments of referral relationships and market footprint.

From a contracting and payment-risk perspective, the combination of an almost exclusively Medicaid revenue base and extreme concentration in ED E/M and IV medication codes suggests the provider is sensitive to Medicaid rate changes and utilization management policies targeting ED utilization and drug administration. Limited Medicare footprint reduces diversification and may constrain negotiating leverage with payers that value a mixed payer panel.

Medicaid: Complete Services Breakdown

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

93 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	60,370	$240	$14.7M
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.	38,830	$250	$9.6M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	22,900	$50	$1.2M
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.	7,200	$160	$1.2M
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,…	8,500	$20	$178.4K
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.	240	$380	$92K
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…	4,840	$20	$82.3K
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…	2,550	$30	$66.4K
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.	190	$260	$50K
97802	The provider treats medical conditions and related symptoms using specific diet therapy by interacting individually with the patient. This code represents each 15 minutes of the first visit with the…	580	$80	$46.5K

Showing 1–10 of 93

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

Hca Health Services Of Tennessee, Inc. — 3 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

93 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	54	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.	34	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.	20	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.	407	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…	44	100	400	$60	$524.7K
G0378	Hospital observation service, per hour	90	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.	109	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.	18	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.	6	120	3,760	$30	$225K
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.	90	170	340	$190	$206.8K

Showing 1–10 of 93

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Omni Visions, Inc.	TN	Foster Care Agency	$0	$133.3M
D&s Residential Services, LP	TN	In Home Supportive Care Agency	$0	$77.7M
Cg Of Tennessee, LLC	TN	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$63.5M
Nashville Pediatric Providers, LLC	TN	Pediatric Nurse Practitioner	$0	$20M
Omni Community Health	TN	Social Worker	$0	$18.2M
Smile Center For Children	TN	Pediatric Dentistry	$0	$9.6M
Option Care Infusion Services, LLC	TN	Home Infusion Therapy Pharmacy	$0	$8.9M
Pediatric Partners Of Nashville, PLLC	TN	Pediatrics Physician	$0	$5.7M
Lifecare Heritage	TN	Adult Day Care Clinic/Center	$0	$4.8M
Oxygen And Sleep Associates, Inc.	TN	Oxygen Equipment & Supplies (DME)	$0	$4.3M

Hca Health Services Of Tennessee, Inc. — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hca Health Services Of Tennessee, Inc.	TN	General Acute Care Hospital	$0	$45.9M
Hca Health Services Of Tennessee, Inc.	TN	General Acute Care Hospital	$0	$28.2M
Hca Health Services Of Tennessee, Inc.	TN	General Acute Care Hospital	$0	$22.1M
Hca Health Services Of Tennessee, Inc.	TN	General Acute Care Hospital	$0	$5.4M