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

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

Tmc Medical Network (NPI 1750832283)

Tmc Medical Network is a multi-specialty clinic/center provider located in Tucson, Arizona. This profile covers 0 Medicare and 143 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	Tmc Medical Network
Address	5301 E Grant Rd
City	Tucson
State	AZ
ZIP	85712
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	October 19, 2016

Payer Source	Total Paid
Medicaid	$20.3M
Medicare	$0

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

143 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	70,530	$60	$4.4M
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…	48,020	$50	$2.3M
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	50,670	$30	$1.7M
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	15,130	$110	$1.6M
76815	The provider performs a limited examination of the fetus using ultrasound. The provider performs the examination of certain parameters for one or more fetuses.	19,970	$50	$1M
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…	7,430	$130	$972.8K
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	7,250	$130	$950K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	8,120	$100	$779.6K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	16,010	$50	$752.3K
59514	The provider admits the patient to the hospital for delivery, delivers the fetus and placenta via an abdominal incision, and provides care immediately after delivery on the same date of service. This…	2,150	$260	$551.3K

Showing 1–10 of 143

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Arizona Distribution

Tmc Medical Network — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arizona

Full comparison — all codes billed, vs. Arizona median

143 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
44970	Laparoscopy, surgical, appendectomy	12	10	110	$4,670	$2.1M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	9	10	4,480	$110	$1.1M
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	9	10	3,790	$100	$1.1M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	8	10	1,510	$340	$994.4K
54161	The provider excises the foreskin of a patient older than 28 days; the provider uses a technique other than a clamp, other devices, or dorsal slit.	9	10	210	$1,570	$931.6K
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	5	10	980	$350	$598.6K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	218	540	900	$60	$475.8K
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…	22	200	410	$170	$442.7K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	382	400	200	$120	$403K
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.	64	180	590	$250	$360.9K

Showing 1–10 of 143

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Arizona Community Physicians PC	AZ	Internal Medicine Physician	$0	$22.5M
Al Shaafi Medical PC	AZ	Pediatrics Physician	$0	$7.6M
Pediatrics Gps, Inc	AZ	Pediatrics Physician	$0	$6.2M
Charles Atkinson	AZ	Surgery Physician	$5.7M	$0
Laurie Chen	AZ	Hematology & Oncology Physician	$1.6M	$0
Basel Shoua	AZ	Hematology & Oncology Physician	$1.4M	$0
Suresh Mukkamala	AZ	Hematology & Oncology Physician	$1.2M	$0
Eric Groskind	AZ	Diagnostic Radiology Physician	$1.1M	$0
Constantin Catalin Boiangiu	AZ	Cardiovascular Disease Physician	$1M	$0
Basel Skeif	AZ	Cardiovascular Disease Physician	$990.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tucson Medical Center	AZ	General Acute Care Hospital	$0	$127.3M
Codac Health Recovery And Wellness	AZ	Community/Behavioral Health Agency	$0	$97.8M
Children's Clinics For Rehabilitative Services	AZ	Multi-Specialty Clinic/Center	$0	$58.8M
Nsi-nursing Service Inc.	AZ	Home Health Agency	$0	$29.8M
Arlene Bautista	AZ	Family Nurse Practitioner	$16.8M	$0
I-groupsmedicaltransportaion@wheelchair	AZ	Non-emergency Medical Transport (VAN)	$0	$15.5M
Bodycentral Physical Therapy P C	AZ	Physical Therapy Clinic/Center	$0	$14.5M
Arizona Oncology Associates PC	AZ	Specialist	$0	$13.9M
Child & Family Support Services, Inc	AZ	Community/Behavioral Health Agency	$0	$13.4M
Caldera Emergency Physicians LLC	AZ	Emergency Medicine Physician	$0	$13.2M

Tmc Medical Network — Billing Profile & Reimbursement Data

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Tmc Medical Network — 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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