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.

Easter Seals West Georgia, Inc (NPI 1073660528)

Field	Value
Entity Type	Organization
Organization	Easter Seals West Georgia, Inc
Address	2515 Double Churches Rd
City	Columbus
State	GA
ZIP	31909
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	January 5, 2007

Payer Source	Total Paid
Medicaid	$14.3M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and is effectively a Medicaid-focused operator, reporting $14.3M in lifetime Medicaid revenue. The absence of Medicare activity means payer exposure is concentrated entirely in state Medicaid programs rather than a dual Medicare/Medicaid mix.

Revenue is extremely concentrated: the precomputed top 3 Medicaid codes account for 100.0% of this provider's Medicaid revenue, with the two documented codes alone representing the full $14.3M. This concentration indicates that a very small set of waiver-related services and supplies drive the provider's entire Medicaid footprint.

The provider's taxonomy (Developmentally Disabled Services Day Training Agency) combined with its top codes (T2025 – Waiver services; not otherwise specified (nos) and T2028 – Specialized supply, not otherwise specified, waiver) indicates operations centered on Medicaid waiver supports for individuals with developmental disabilities, delivering both recurring waiver services and specialized supply items. The code mix is consistent with a day-training/support model supplemented by supply provision under waiver authorities.

T2025 is the largest single revenue driver at $8.6M (37.1K claims, $232 avg paid/claim) and accounts for 60.0% of this provider's total Medicaid revenue; the provider ranks #12 of 30 in-state (62th percentile), which the data characterizes as typical, unremarkable volume. The high claim count with a lower average paid/claim suggests high-frequency, lower-intensity service deliveries consistent with recurring support or day-program billing.

T2028 is the other major driver at $5.7M (17.9K claims, $321 avg paid/claim) and accounts for 40.0% of Medicaid revenue; the provider ranks #1 of 17 in-state (100th percentile) and is labeled notably above typical state volume. The higher avg paid/claim and top statewide rank indicate this provider is a dominant supplier of specialized waiver supplies in Georgia relative to peers.

Competitive standing is mixed: the provider is a clear statewide leader for T2028 (specialized supplies) but a mid-tier participant for T2025 (waiver services). This suggests a niche of strength in supplying specialized goods under waiver programs while maintaining only typical market share on the broader waiver-service side.

The NPI was enumerated 2007-01-05 (~19 years ago), signaling long tenure in the Medicaid system and likely established relationships with state waiver administrators and care coordinators. This longevity supports continuity in billing patterns and market position.

Because two waiver-related codes represent 100.0% of reported Medicaid revenue, the provider's financial performance is sensitive to changes in state waiver policy, reimbursement rates, or utilization rules for those codes. The higher average paid/claim for T2028 relative to T2025 also means shifts in supply reimbursement would disproportionately affect overall revenue, so monitoring fee schedules and waiver amendments is important for assessing future revenue risk.

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
T2025	Waiver services; not otherwise specified (nos)	37,090	$230	$8.6M
T2028	Specialized supply, not otherwise specified, waiver	17,860	$320	$5.7M

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

Easter Seals West Georgia, Inc — 1 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
T2025	Waiver services; not otherwise specified (nos)	12	30	15,890	$130	$7.5M
T2028	Specialized supply, not otherwise specified, waiver	1	20	2,190	$210	$854K

Nearby Providers

Other providers in the same ZIP code as Easter Seals West Georgia, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rivertown Psychiatry, PC	GA	Psychiatry Physician	$0	$4.2M
North Columbus Surgery Center LLC	GA	Ambulatory Surgical Clinic/Center	$1.2M	$0
Hughston Clinic, P.C.	GA	Orthopaedic Surgery Physician	$0	$789.9K
Hughston Surgical Center LLC	GA	Ambulatory Surgical Clinic/Center	$589.8K	$0
John Dorchak	GA	Orthopaedic Surgery Physician	$458.7K	$0
Pediatric Acute Care Of Columbus, P.C.	GA	Pediatrics Physician	$0	$376.3K
Garland Gudger	GA	Orthopaedic Surgery Physician	$350.4K	$0
Hares Akbary	GA	Pain Medicine (Anesthesiology) Physician	$331.8K	$0
Randall Ruark	GA	Orthopaedic Surgery Physician	$291.5K	$0
Patrick Fernicola	GA	Orthopaedic Surgery Physician	$239.5K	$0

Easter Seals West Georgia, Inc — Billing Profile & Reimbursement Data

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Easter Seals West Georgia, Inc — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References