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.

Phillip R. Bowden, M.d.,p.a. (NPI 1932216389)

Phillip R. Bowden, M.d.,p.a. is a gastroenterology physician provider located in Memphis, Tennessee. This profile covers 0 Medicare and 49 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	Phillip R. Bowden, M.d.,p.a.
Address	1417 Monroe Ave
City	Memphis
State	TN
ZIP	38104
Taxonomy	Gastroenterology Physician
NPI Enumerated	August 23, 2006

Payer Source	Total Paid
Medicaid	$4.6M
Medicare	$0

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

49 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	10,010	$90	$881.2K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	7,620	$80	$617.1K
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.	5,250	$100	$498.8K
99203	The provider sees a new 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 provider…	13,380	$40	$481.5K
88312	The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets…	3,950	$90	$343.5K
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…	13,070	$20	$300.6K
00731	The anesthesia provider performs anesthesia services for an unspecified type of upper gastrointestinal endoscopic procedure during which another provider introduces the endoscope to but not beyond…	3,550	$60	$198.9K
45388	In this procedure, the provider performs flexible colonoscopy to destroy one or more tumors, polyps, or other lesions. The procedure includes, but does not require, guide wire passage and dilating…	1,360	$150	$198.4K
76700	An abdominal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. liver, gallbladder, pancreas, bile ducts, spleen, and abdominal aorta). This particular code…	4,320	$50	$194.2K
00811	The provider performs anesthesia services for a patient undergoing an unspecified lower intestinal endoscopic procedure where the surgical provider introduces an endoscope into the intestines up to…	2,120	$50	$106.2K

Showing 1–10 of 49

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

Phillip R. Bowden, M.d.,p.a. — 15 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

49 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	10	170	340	$190	$206.8K
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…	1,720	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…	320	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…	18	200	600	$30	$168.3K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	2	80	70	$200	$121.4K
45388	In this procedure, the provider performs flexible colonoscopy to destroy one or more tumors, polyps, or other lesions. The procedure includes, but does not require, guide wire passage and dilating…	1	10	420	$160	$94K
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…	160	1,080	120	$80	$90.7K
43450	The provider passes long thin tubular devices of increasing diameter to dilate, or widen, a stricture in the patient’s esophagus to improve swallowing.	5	30	170	$60	$62.4K
99203	The provider sees a new 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 provider…	14	1,240	120	$60	$53.1K
91120	N/A	1	10	280	$180	$50K

Showing 1–10 of 49

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Phillip Bowden	TN	Specialist	$89.6K	$0
Sheryl Buchanan-foster	TN	Family Nurse Practitioner	$69.1K	$0
Teddy Winney	TN	Certified Registered Nurse Anesthetist	$43.3K	$0
Kathleen Weiman	TN	Certified Registered Nurse Anesthetist	$14.3K	$0
Sharon Lucus	TN	Certified Registered Nurse Anesthetist	$8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Methodist Healthcare - Memphis Hospitals	TN	General Acute Care Hospital	$0	$105.6M
Primary Care Group LLC	TN	Family Medicine Physician	$0	$23.5M
Well Child Inc.	TN	Nurse Practitioner	$0	$19.8M
Bhg Reference Lab, LLC	TN	Clinical Medical Laboratory	$0	$14M
Wci School Health Services, PLLC	TN	Family Nurse Practitioner	$0	$10.4M
Memphis Radiological, P.C.	TN	Diagnostic Radiology Physician	$0	$9.1M
Memphis Medical Center Air Ambulance Service, Inc.	TN	Air Ambulance	$0	$6.5M
Southern College Of Optometry	TN	Optometrist	$0	$5.4M
Satellite Healthcare Of Poplar Avenue LLC	TN	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$5.2M
Methodist Inpatient Physicians LLC	TN	Internal Medicine Physician	$0	$4.8M

Phillip R. Bowden, M.d.,p.a. — 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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