Physician
Sumner Regional Medical Center LLC
Sumner Regional Medical Center LLC was paid $11.82M by Medicaid between Jan 2018 and Nov 2024, across 81 billing codes. Its largest line is 99284, emergency room visit (serious) — 42% of everything it billed.
33Billing provider infoSUMNER REGIONAL MEDICAL CENTER LLC
GALLATIN, TN 37066
GALLATIN, TN 37066
33aNPI1447571658assigned 06/22/2010
33bProvider typeEmergency Medicine Physician
28Total paid$11.82M
24GClaims192,499
24DCodes billed81
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Emergency Medicine Physician providers in Tennessee
Rank by total paid#4 of 332
Median peer was paid$56K
This provider vs. median210×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official LAWRENCE, CHARLOTTE controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 37,435 | $2.28M | |
| 2019 | 37,919 | $2.07M | |
| 2020 | 23,639 | $1.45M | |
| 2021 | 24,789 | $1.51M | |
| 2022 | 24,938 | $1.57M | |
| 2023 | 28,153 | $1.70M | |
| 2024incomplete | 15,626 | $1.23M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 42% | 28,257 | 24,605 | $4.91M |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 33% | 28,541 | 25,871 | $3.88M |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 7.6% | 5,535 | 4,497 | $904K |
| G0378 | Hospital observation service, per hour | 5.9% | 3,996 | 2,148 | $694K |
| 41899 | Unlisted procedure, dentoalveolar structures | 2.8% | 881 | 838 | $325K |
| 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | 1.9% | 2,065 | 1,920 | $225K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 1.2% | 35,524 | 28,771 | $139K |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | <1% | 6,687 | 3,649 | $102K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 7,302 | 6,240 | $94K |
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r | <1% | 1,559 | 1,403 | $77K |
| 80053 | Comprehensive metabolic panel | <1% | 23,432 | 19,402 | $70K |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 3,805 | 3,459 | $39K |
69 more codes
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | <1% | 336 | $34K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 948 | $33K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 120 | $32K |
| 84484 | <1% | 2,456 | $26K | |
| 71260 | Computed tomography, thorax, diagnostic; with contrast material | <1% | 291 | $20K |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | <1% | 353 | $20K |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | <1% | 311 | $19K |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 2,029 | $17K |
| 59025 | Fetal non-stress test | <1% | 324 | $17K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | <1% | 50 | $17K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | <1% | 265 | $16K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 4,418 | $15K |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 | <1% | 713 | $13K |
| 83690 | <1% | 2,446 | $11K | |
| 81001 | <1% | 10,615 | $9K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 296 | $8K |
| 71045 | Radiologic examination, chest; single view | <1% | 2,822 | $8K |
| 96361 | Intravenous infusion, hydration; each additional hour | <1% | 1,186 | $6K |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 1,224 | $6K |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 3,184 | $4K |
| 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | <1% | 15 | $3K |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 89 | $3K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 147 | $3K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 107 | $2K |
| 71046 | Radiologic examination, chest; 2 views | <1% | 397 | $2K |
| 87071 | <1% | 1,784 | $2K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 240 | $1K |
| 94726 | <1% | 98 | $1K | |
| 96376 | <1% | 164 | $781.59 | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 176 | $772.70 |
| 94626 | <1% | 178 | $757.75 | |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 17 | $587.12 |
| 94729 | <1% | 79 | $579.57 | |
| 82962 | <1% | 334 | $572.03 | |
| 84703 | <1% | 109 | $533.81 | |
| 83880 | <1% | 97 | $430.42 | |
| 80306 | <1% | 39 | $392.97 | |
| 87430 | <1% | 76 | $389.23 | |
| 94060 | <1% | 16 | $387.30 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 423 | $336.06 |
| 97597 | <1% | 31 | $288.80 | |
| 87081 | <1% | 71 | $246.89 | |
| 85027 | <1% | 178 | $242.38 | |
| 94669 | <1% | 184 | $222.13 | |
| 81025 | <1% | 92 | $195.84 | |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 17 | $149.12 |
| 94618 | <1% | 16 | $138.66 | |
| 82565 | <1% | 67 | $126.39 | |
| 81003 | <1% | 235 | $122.34 | |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | <1% | 18 | $78.07 |
| 85610 | <1% | 77 | $60.82 | |
| 80061 | Lipid panel | <1% | 12 | $57.15 |
| 87205 | <1% | 21 | $22.42 | |
| J2765 | Injection, metoclopramide hcl, up to 10 mg | <1% | 13 | $7.82 |
| G0307 | Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) | <1% | 15 | $5.47 |
| J3010 | Injection, fentanyl citrate, 0.1 mg | <1% | 706 | $5.45 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 619 | $1.00 |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 0% | 579 | $0.00 |
| J7030 | Infusion, normal saline solution , 1000 cc | 0% | 681 | $0.00 |
| 86900 | 0% | 37 | $0.00 | |
| J7120 | Ringers lactate infusion, up to 1000 cc | 0% | 20 | $0.00 |
| 87339 | 0% | 15 | $0.00 | |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 0% | 326 | $0.00 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | 0% | 966 | $0.00 |
| J2704 | Injection, propofol, 10 mg | 0% | 843 | $0.00 |
| 86850 | 0% | 37 | $0.00 | |
| 86901 | 0% | 37 | $0.00 | |
| J7512 | Prednisone, immediate release or delayed release, oral, 1 mg | 0% | 18 | $0.00 |
| A9270 | Non-covered item or service | 0% | 12 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialLAWRENCE, CHARLOTTE (SECRETARY)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.