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.

Blue Ridge Radiology, P.C. (NPI 1881687689)

Blue Ridge Radiology, P.C. is a diagnostic radiology physician provider located in Bristol, Tennessee. This profile covers 0 Medicare and 70 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	Blue Ridge Radiology, P.C.
Address	933 Highway 126
City	Bristol
State	TN
ZIP	37620
Taxonomy	Diagnostic Radiology Physician
NPI Enumerated	August 26, 2005

Payer Source	Total Paid
Medicaid	$4.2M
Medicare	$0

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

70 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	28,230	$40	$1.2M
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	35,710	$20	$535.6K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	10,160	$40	$396.4K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	113,660	$1	$341K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	57,210	$10	$286K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	15,580	$20	$280.4K
71275	In this procedure, the provider performs a computed tomographic angiography, or CTA imaging of the chest to get detailed images of the blood vessels but not the heart. He performs this study using a…	3,720	$40	$137.7K
72148	In this diagnostic procedure, the provider performs magnetic resonance imaging (MRI) of the lumbar spinal canal and contents without using contrast.	3,870	$30	$131.6K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	2,240	$50	$109.7K
77063	The provider captures three dimensional images of the breast using X–rays at various angles for routine checkup. He checks for the presence of any abnormality within the breasts. Tomosynthesis…	6,850	$10	$89K

Showing 1–10 of 70

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

Blue Ridge Radiology, P.C. — 9 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

70 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	47	100	670	$60	$342.9K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	54	150	390	$60	$220.9K
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.	8	210	400	$50	$157.2K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	12	50	170	$110	$131.5K
70551	The provider uses magnetic resonance imaging, or MRI, to examine the brain and brain stem. The provider does not administer contrast for this exam.	11	50	130	$70	$104K
76817	The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.	77	120	300	$60	$89.7K
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…	91	150	210	$70	$85.6K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	8	230	460	$20	$83K
78815	PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.…	3	30	90	$170	$78.8K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	7	170	170	$40	$63.7K

Showing 1–10 of 70

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kalpesh Patel	AZ	Diagnostic Radiology Physician	$409.1K	$0
Kyle Schuller	AL	Diagnostic Radiology Physician	$298K	$0
Jim Gray	MS	Diagnostic Radiology Physician	$283.4K	$1.9K
Creed Rucker	AZ	Diagnostic Radiology Physician	$271.1K	$0
David Forsberg	TN	Diagnostic Radiology Physician	$170.4K	$70K
Joseph Harpole	TN	Diagnostic Radiology Physician	$160.7K	$41.8K
Jonathan Enterline	PA	Diagnostic Radiology Physician	$187.4K	$12.1K
Preston Fox	VA	Vascular & Interventional Radiology Physician	$184.5K	$130
Jason Pearce	GA	Diagnostic Radiology Physician	$168.7K	$0
Khoa Tran	GA	Diagnostic Radiology Physician	$164.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wellmont Health System	TN	General Acute Care Hospital	$0	$27.3M
Bristol Pediatric Dentistry PLLC	TN	Pediatric Dentistry	$0	$23.4M
Ipc Pac Healthcare Services Of Tennessee PC	TN	Internal Medicine Physician	$0	$8.5M
Youthcare Pediatrics	TN	Pediatrics Physician	$0	$3.1M
Applachian Recovery Care, PLLC	TN	Addiction Medicine (Internal Medicine) Physician	$0	$2.4M
Ambulance Service Of Bristol Inc	TN	Ambulance	$836.3K	$1.5M
Mountain Empire Cataract & Eye Surgery Center	TN	Ambulatory Surgical Clinic/Center	$953.1K	$929.5K
The Endoscopy Center Of Bristol	TN	Ambulatory Surgical Clinic/Center	$508.4K	$181.3K
Renaissance Surgery Center, LLC	TN	Ambulatory Surgical Clinic/Center	$669.7K	$0
Rick Whiles	TN	Internal Medicine Physician	$634.1K	$0

Blue Ridge Radiology, P.C. — Billing Profile & Reimbursement Data

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Blue Ridge Radiology, P.C. — 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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