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.

Tennessee Oncology PLLC (NPI 1811955917)

Tennessee Oncology PLLC is a hematology & oncology physician provider located in Nashville, Tennessee. This profile covers 0 Medicare and 77 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	Tennessee Oncology PLLC
Address	2004 Hayes St Ste 800
City	Nashville
State	TN
ZIP	37203
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	May 1, 2006

Payer Source	Total Paid
Medicaid	$8.5M
Medicare	$0

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

77 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…	57,960	$30	$1.9M
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	29,330	$60	$1.6M
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…	29,400	$50	$1.4M
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…	277,440	$1	$832.3K
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…	20,740	$20	$456.3K
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.	104,440	$1	$417.8K
88185	The lab analyst performs the technical component of a flow cytometry procedure using cell surface, cytoplasmic, or nuclear markers to characterize cells and aid clinicians in diagnosing patients with…	1,600	$210	$333.2K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	9,450	$30	$321.3K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	161,810	$1	$161.8K
96367	The provider administers an additional intravenous infusion or infusions, after an initial infusion, of a different medication or substance for a period up to one hour to prevent, treat, or diagnose…	7,390	$20	$147.8K

Showing 1–10 of 77

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

Tennessee Oncology PLLC — 12 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

77 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
88185	The lab analyst performs the technical component of a flow cytometry procedure using cell surface, cytoplasmic, or nuclear markers to characterize cells and aid clinicians in diagnosing patients with…	3	10	770	$140	$500.5K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	248	360	350	$50	$414.4K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	2	40	1,860	$70	$294.9K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	108	120	3,760	$30	$225K
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…	50	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…	207	4,050	620	$30	$183.9K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	168	200	600	$30	$168.3K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	128	210	400	$50	$157.2K
J1439	Injection, ferric carboxymaltose, 1 mg	4	10	190	$530	$104K
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…	425	1,080	120	$80	$90.7K

Showing 1–10 of 77

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
James Gray	TN	Radiation Oncology Physician	$4.9M	$0
Mark Womack	TN	Hematology & Oncology Physician	$2.4M	$0
Bertrand Anz	TN	Hematology & Oncology Physician	$2.4M	$0
Dana Thompson	TN	Medical Oncology Physician	$2.2M	$0
Kent Shih	TN	Hematology & Oncology Physician	$2.2M	$0
Joshua Mondschein	TN	Radiation Oncology Physician	$2.1M	$0
Derek Holland	TN	Hematology & Oncology Physician	$2M	$0
Josiah Magnusson	FL	Nuclear Medicine Physician	$1.8M	$0
William Donnellan	TN	Hematology & Oncology Physician	$1.7M	$0
Clint Kingsley	AL	Hematology & Oncology Physician	$1.6M	$22K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hca Health Services Of Tennessee, Inc.	TN	General Acute Care Hospital	$0	$45.9M
Pediatrix Medical Group Of Tennessee, P.C.	TN	Neonatal-Perinatal Medicine Physician	$0	$32.3M
Saint Thomas Medical Partners	TN	Internal Medicine Physician	$0	$21.9M
Radiology Alliance PC	TN	Diagnostic Radiology Physician	$0	$13.2M
Emergency Medicine Services Of Tn, PC	TN	Emergency Medicine Physician	$0	$12.9M
Tennessee Maternal-fetal Medicine LLC	TN	Specialist	$0	$12.5M
The Next Door, Inc.	TN	Substance Abuse Rehabilitation Facility	$0	$8.6M
Vcphcs Ix, LLC	TN	Substance Use Disorder Rehabilitation Clinic/Center	$257.7K	$6.6M
Tennessee Retina PC	TN	Retina Specialist (Ophthalmology) Physician	$0	$6M
Pediatric Associates Of Davidson County, P.C.	TN	Pediatrics Physician	$0	$5.8M

Tennessee Oncology PLLC — Billing Profile & Reimbursement Data

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Tennessee Oncology PLLC — 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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