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 Alabama for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Alabama 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. Alabama (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.

Nes Tennessee Inc (NPI 1720507635)

Field	Value
Entity Type	Organization
Organization	Nes Tennessee Inc
Address	315 W Hickory St
City	Sylacauga
State	AL
ZIP	35150
Taxonomy	Emergency Medicine Physician
NPI Enumerated	September 12, 2017

Payer Source	Total Paid
Medicaid	$2.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

12 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.	20,730	$50	$1.1M
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.	11,510	$80	$886K
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.	8,940	$30	$286K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	4,140	$1	$16.5K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	100	$60	$5.9K
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.	40	$20	$740
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	50	$0	$0
G8783	Normal blood pressure reading documented, follow-up not required	90	$0	$0
G8952	Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given	500	$0	$0
G9744	Patient not eligible due to active diagnosis of hypertension	310	$0	$0

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Alabama providers billing the same CPT/HCPCS codes.

Claims Volume vs. Alabama Distribution

Nes Tennessee Inc — 0 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. Alabama median

12 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.	41	240	4,820	$60	$807.6K
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.	21	190	1,480	$100	$730.7K
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.	86	230	5,160	$40	$474.1K
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.	111	130	420	$40	$106K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	40	60	270	$110	$94.3K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	43	170	890	$10	$25.2K
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	30	50	80	$1	$510
G8952	Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given	6	10	500	$1	$10
G8783	Normal blood pressure reading documented, follow-up not required	22	40	90	$0	$0
G9744	Patient not eligible due to active diagnosis of hypertension	16	30	260	$0	$0

Showing 1–10 of 12

Related Providers

Other providers that share a Tax Identification Number (TIN) with Nes Tennessee Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nes Tennessee Inc	AL	Emergency Medicine Physician	$0	$1.8M
Nes Tennessee Inc	AL	Emergency Medicine Physician	$0	$1.4M
Nes Tennessee Inc	AL	Emergency Medicine Physician	$0	$911.1K
Michael Coulthard	GA	Family Medicine Physician	$83.1K	$0
Dennis Laird	CT	Emergency Medicine Physician	$68.3K	$0
Brian Guffin	AL	Specialist	$52.8K	$0
Urmil Patel	AL	Emergency Medicine Physician	$51.2K	$0
William Saliski	AL	Family Nurse Practitioner	$34K	$0

Nearby Providers

Other providers in the same ZIP code as Nes Tennessee Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pathway Pediatrics, Inc.	AL	Pediatrics Physician	$0	$8.6M
Sylacauga Pediatric Clinic, LLC	AL	Rural Health Clinic/Center	$0	$7.4M
Sylacauga Pediatric Clinic, LLC	AL	Pediatrics Physician	$0	$4.4M
Sylacauga Health Care Authority Inc	AL	Rural Acute Care Hospital	$0	$4.2M
Marble City Pediatric Dentistry	AL	Preferred Provider Organization	$0	$2.2M
Sylacauga Ambulance Service, Inc.	AL	Land Ambulance	$433.6K	$958.7K
Talladega County Health Dept-sylacauga Epsdt Cm	AL	Case Management Agency	$0	$1.2M
Family Eye Care Of Sylacauga LLC	AL	Optometrist	$0	$1.2M
Talladega County Health Dept-sylacauga Fp Clinic	AL	Public Health or Welfare Agency	$0	$951.3K
Hamo Neurology Clinic	AL	Neurology Physician	$0	$943.7K

Nes Tennessee Inc — Billing Profile & Reimbursement Data

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Nes Tennessee 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

Related Providers

Nearby Providers

Frequently Asked Questions

References