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 Alabama for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Alabama 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. Alabama (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.

Professional Resource Management Of Wiregrass, LLC (NPI 1033495221)

Professional Resource Management Of Wiregrass, LLC is a psychiatry physician provider located in Dothan, Alabama. This profile covers 0 Medicare and 111 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	Professional Resource Management Of Wiregrass, LLC
Address	2812 Hartford Hwy Ste 1
City	Dothan
State	AL
ZIP	36305
Taxonomy	Psychiatry Physician
NPI Enumerated	November 1, 2011

Payer Source	Total Paid
Medicaid	$9M
Medicare	$0

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

111 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…	48,910	$40	$1.9M
G0482	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	10,320	$90	$939K
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	4,990	$170	$833.5K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	17,200	$40	$739.4K
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…	10,250	$70	$676.7K
86769	The lab analyst performs a multiple–step immunoassay to evaluate the patient’s serum for antibodies to severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), which causes coronavirus disease…	18,890	$20	$434.5K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	3,600	$100	$367.3K
U0004	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…	7,180	$40	$280.2K
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…	4,260	$60	$251.5K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	11,820	$20	$200.9K

Showing 1–10 of 111

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Alabama providers billing the same CPT/HCPCS codes.

Claims Volume vs. Alabama Distribution

Professional Resource Management Of Wiregrass, LLC — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. Alabama median

111 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	19	60	1,260	$60	$1.2M
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	13	100	470	$130	$1.2M
83520	The lab analyst measures the analyte, which is not an infectious agent antibody or infectious agent antigen, by immunoassay. Use 83520 for procedures that have no specific code assigned for the…	4	10	140	$20	$1.1M
U0004	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…	9	20	10,040	$40	$825.9K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	17	180	100	$120	$381.8K
87581	The lab analyst performs a test for Mycoplasma pneumonia, a bacteria, using amplified nucleic acid probe technique.	12	40	1,440	$20	$372.1K
87486	The lab analyst performs a test for Chlamydia pneumoniae using amplified nucleic acid probe technique. Chlamydia pneumoniae also known as TWAR, Taiwan Acute Respiratory agent, commonly causes mild…	12	40	2,000	$20	$273.5K
87641	The lab analyst performs a test for methicillin–resistant Staphylococcus aureus (MRSA) using an amplified nucleic acid probe technique.	14	10	3,980	$10	$225.2K
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,…	12	40	860	$10	$212K
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…	153	1,990	680	$60	$201.7K

Showing 1–10 of 111

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Clifford Quintana	AL	Family Medicine Physician	$191.6K	$0
Kenneth Roberts	AL	Family Medicine Physician	$41.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southeastern Pediatric Associates, P.A.	AL	Pediatrics Physician	$0	$17.3M
Triad Of Alabama LLC	AL	General Acute Care Hospital	$0	$4.6M
Hejal Patel	AL	Radiation Oncology Physician	$2.2M	$0
Wiregrass Wellness Center, LLC	AL	Psychiatry Physician	$0	$1.6M
Ent Care PC	AL	Specialist	$0	$866.8K
Circle City Speech, LLC	AL	Speech-Language Pathologist	$0	$852.8K
Kirk Sturridge	AL	Ophthalmology Physician	$715.4K	$0
Alabama Eye Surgery Center LLC	AL	Ambulatory Surgical Clinic/Center	$657.1K	$0
Craig Omohundro	AL	Dermatology Physician	$466.7K	$0
Paul Lamb	AL	Gastroenterology Physician	$431.3K	$0

Professional Resource Management Of Wiregrass, LLC — Billing Profile & Reimbursement Data

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Professional Resource Management Of Wiregrass, 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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