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.

Erlanger Health (NPI 1861194086)

Field	Value
Entity Type	Organization
Organization	Erlanger Health
Address	975 E 3rd St
City	Chattanooga
State	TN
ZIP	37403
Taxonomy	General Acute Care Hospital
NPI Enumerated	March 21, 2023

Payer Source	Total Paid
Medicaid	$3.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

75 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.	11,950	$70	$824.5K
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.	5,570	$140	$752.2K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	670	$490	$323.7K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	1,130	$210	$232K
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.	1,070	$200	$216.1K
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	400	$520	$206.8K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	1,450	$90	$133.1K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	1,200	$80	$97.2K
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…	3,910	$20	$66.5K
93325	The provider performs Doppler echocardiography, a diagnostic procedure based on the Doppler effect of sound, color flow velocity mapping, a two–dimensional image representation of blood flow in the…	370	$150	$55.4K

Showing 1–10 of 75

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

Erlanger Health — 0 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

75 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	43	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.	140	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.	91	610	570	$110	$884.4K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	13	30	410	$520	$719.2K
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.	197	570	640	$100	$637.8K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	40	50	140	$850	$541.1K
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	11	20	1,060	$210	$535.6K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	48	70	160	$500	$421.5K
G0378	Hospital observation service, per hour	86	100	410	$210	$264K
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.	141	180	480	$90	$245.5K

Showing 1–10 of 75

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chattanooga Hamilton County Hospital Authority	TN	General Acute Care Hospital	$0	$52.4M
Chattanooga Hamilton County Hospital Authority	TN	Internal Medicine Physician	$0	$27.9M
Chattanooga Hamilton County Hospital Authority	TN	Critical Access Hospital	$0	$5.6M
Erlanger Health	TN	Internal Medicine Physician	$0	$2.3M
Erlanger Behavioral Health, LLC	TN	Psychiatric Hospital	$0	$2.2M
Medical Foundation, Inc.	MS	Geriatric Medicine (Family Medicine) Physician	$0	$1.8M
Clint Kingsley	AL	Hematology & Oncology Physician	$1.6M	$22K
Robert Graham	TN	Hematology & Oncology Physician	$1.2M	$19.8K
Harsha Vardhana	TN	Medical Oncology Physician	$941.1K	$66.6K
Sreejit Nair	NC	Vascular Surgery Physician	$658K	$0

Nearby Providers

Other providers in the same ZIP code as Erlanger Health, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Regional Obstetrical Consultants PC	TN	Maternal & Fetal Medicine Physician	$0	$14.2M
Tennessee River Physicians, PLLC	TN	Emergency Medicine Physician	$0	$3.9M
Southeastern Emergency Services Of Memphis, P.C.	TN	Emergency Medicine Physician	$0	$3.8M
Tennessee Interventional And Imaging Associates, PLLC	TN	Diagnostic Radiology Physician	$0	$3.4M
Hearth Hospice Of Tennessee, LLC	TN	Community Based Hospice Care Agency	$0	$2.8M
Sumana Nagireddy	TN	Hematology & Oncology Physician	$836.4K	$0
Brett Gerwin	TN	Ophthalmology Physician	$725.5K	$60
Michael Goodman	TN	Gastroenterology Physician	$473.6K	$0
Harigovinda Challa	TN	Diagnostic Radiology Physician	$154.9K	$257.6K
David Bowers	TN	Physical Medicine & Rehabilitation Physician	$410.4K	$0

Erlanger Health — Billing Profile & Reimbursement Data

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Erlanger Health — 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