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.

Vanderbilt Integrated Providers, LLC (NPI 1982625091)

Vanderbilt Integrated Providers, LLC is a family medicine physician provider located in Nashville, Tennessee. This profile covers 0 Medicare and 103 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	Vanderbilt Integrated Providers, LLC
Address	1161 21st Ave S
City	Nashville
State	TN
ZIP	37232
Taxonomy	Family Medicine Physician
NPI Enumerated	July 22, 2006

Payer Source	Total Paid
Medicaid	$4.3M
Medicare	$0

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

103 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…	29,680	$40	$1.2M
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…	21,750	$50	$1.1M
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.	13,100	$30	$406K
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…	5,960	$70	$393.2K
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…	5,460	$70	$376.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2,340	$70	$154.1K
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…	1,830	$70	$118.8K
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	50	$1,420	$76.5K
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.	5,780	$10	$75.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	790	$70	$57.7K

Showing 1–10 of 103

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

Vanderbilt Integrated Providers, LLC — 3 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

103 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	50	80	100	$1,260	$405.3K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	45	60	320	$140	$346.9K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	75	150	390	$60	$220.9K
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.	74	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…	144	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…	67	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…	143	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…	59	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.	92	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…	197	240	510	$50	$125.9K

Showing 1–10 of 103

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vanderbilt University Medical Center	TN	Internal Medicine Physician	$0	$189.5M
Vanderbilt University Medical Center	TN	General Acute Care Hospital	$0	$137.7M
Vanderbilt University Medical Center	TN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$29.1M
Vanderbilt University Medical Center	TN	General Acute Care Hospital	$0	$8M
Antonia Kolokythas	TN	Oral and Maxillofacial Surgery (Dentist)	$0	$5.9M
Heather Tamez	MD	Retina Specialist (Ophthalmology) Physician	$1.3M	$0
Kenneth Niermann	TN	Radiation Oncology Physician	$625.8K	$0
Stephen Kim	TN	Ophthalmology Physician	$608.9K	$0
Corbin Johnson	TN	Radiation Oncology Physician	$577.1K	$0
Avni Finn	TN	Ophthalmology Physician	$504.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Han-chih Chang	TN	Radiation Oncology Physician	$2.6M	$0
Emily Carpenter	TN	Nurse Practitioner	$747.9K	$0
Dinesh Gupta	TN	Cardiovascular Disease Physician	$397.9K	$80.2K
Dong Kim	TN	Radiation Oncology Physician	$469.4K	$0
Anthony Cmelak	TN	Radiation Oncology Physician	$391.9K	$0
Ryszard Dworski	TN	Allergy & Immunology Physician	$376.5K	$2.4K
Nathan Podoll	TN	Ophthalmology Physician	$363.9K	$0
Brian Thurber	TN	Diagnostic Radiology Physician	$356K	$0
Reagan Leverett	TN	Diagnostic Radiology Physician	$337.1K	$0
Collier King	TN	Diagnostic Radiology Physician	$336.3K	$0

Vanderbilt Integrated Providers, LLC — Billing Profile & Reimbursement Data

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Vanderbilt Integrated Providers, 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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