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

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

Modify Health Inc (NPI 1063184737)

Field	Value
Entity Type	Organization
Organization	Modify Health Inc
Address	190 Bluegrass Valley Pkwy
City	Alpharetta
State	GA
ZIP	30005
Taxonomy	Community Health Worker
NPI Enumerated	October 1, 2021

Payer Source	Total Paid
Medicaid	$5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5170	Home delivered meals, including preparation; per meal	45,260	$110	$5M
S9470	Nutritional counseling, dietitian visit	1,560	$40	$54.7K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Georgia Distribution

Modify Health Inc — 0 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. Georgia median

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5170	Home delivered meals, including preparation; per meal	2	10	45,260	$60	$1.9M
S9470	Nutritional counseling, dietitian visit	1	10	1,560	$30	$54K

Nearby Providers

Other providers in the same ZIP code as Modify Health Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bakotic Pathology Associates, LLC	GA	Clinical Medical Laboratory	$101.5K	$13.3M
Scott Acker	GA	Dermatopathology (Pathology) Physician	$3.8M	$0
Tots, Inc.	GA	Pediatric Occupational Therapist	$0	$3M
Pain & Spine Physicians Surgery Center LLC	GA	Ambulatory Surgical Clinic/Center	$1.9M	$0
Darren Harris	GA	Anatomic Pathology & Clinical Pathology Physician	$1.4M	$0
William Betsill	GA	Clinical Medical Laboratory	$1.3M	$0
John Grimwood	GA	Anatomic Pathology & Clinical Pathology Physician	$1.2M	$0
Carolina Montes	GA	Anatomic Pathology & Clinical Pathology Physician	$1.1M	$0
Eli Piatigorsky	GA	Dermatopathology Physician	$1.1M	$0
Wiles Therapy Services Inc	GA	Pediatric Occupational Therapist	$0	$985.5K

Modify Health Inc — Billing Profile & Reimbursement Data

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Modify Health Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References