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.

Tullahoma Hma Physician Management, LLC (NPI 1831114099)

Tullahoma Hma Physician Management, LLC is a internal medicine physician provider located in Tullahoma, Tennessee. This profile covers 0 Medicare and 61 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	Tullahoma Hma Physician Management, LLC
Address	1940 N Jackson St
City	Tullahoma
State	TN
ZIP	37388
Taxonomy	Internal Medicine Physician
NPI Enumerated	July 12, 2006

Payer Source	Total Paid
Medicaid	$2.2M
Medicare	$0

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

61 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	21,880	$40	$831.6K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	4,140	$70	$273K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	4,610	$60	$272K
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…	4,530	$40	$185.8K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	4,020	$40	$140.7K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	4,030	$30	$100.8K
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…	1,270	$70	$91.7K
J0561	Injection, penicillin g benzathine, 100,000 units	670	$90	$58.3K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	2,000	$30	$57.9K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	6,730	$10	$53.8K

Showing 1–10 of 61

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

Tullahoma Hma Physician Management, LLC — 1 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

61 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	164	610	1,220	$40	$206K
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…	625	3,760	610	$40	$202.3K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	80	520	470	$70	$187K
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…	197	4,050	620	$30	$183.9K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	71	480	580	$60	$174.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	174	510	240	$70	$133.7K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	137	240	510	$50	$125.9K
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…	125	1,080	120	$80	$90.7K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	185	620	740	$20	$88.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	360	420	150	$80	$81.8K

Showing 1–10 of 61

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dinesh Gupta	TN	Cardiovascular Disease Physician	$397.9K	$80.2K
Martin Fiala	TN	Orthopaedic Surgery Physician	$43.3K	$0
Ginny Barton	TN	Obstetrics & Gynecology Physician	$3.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Skills Development Services, Inc.	TN	Developmentally Disabled Services Day Training Agency	$0	$9M
Tullahoma Pediatrics PLLC	TN	Pediatrics Physician	$0	$6.1M
Vanderbilt Coffee Hospital, LLC	TN	General Acute Care Hospital	$0	$4.1M
Tullahoma Hma LLC	TN	General Acute Care Hospital	$0	$4M
Robert Collier	TN	Retina Specialist (Ophthalmology) Physician	$1.1M	$0
Isaac Bryan	TN	Dermatology Physician	$896K	$0
Ambulatory Surgical Associates LLC	TN	Ambulatory Surgical Clinic/Center	$785.7K	$0
Charles Drummond	TN	Vascular Surgery Physician	$708.5K	$8.9K
William Bradford	TN	Radiation Oncology Physician	$438.6K	$0
Stephen Bills	TN	Internal Medicine Physician	$242.7K	$1.3K

Tullahoma Hma Physician Management, LLC — Billing Profile & Reimbursement Data

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Tullahoma Hma Physician Management, LLC — 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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