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.

William Tidmore (NPI 1073695292)

Field	Value
Entity Type	Individual
Organization	William Tidmore
Address	2418 N Oak St
City	Valdosta
State	GA
ZIP	31602
Taxonomy	Rheumatology Physician
NPI Enumerated	October 19, 2006

Payer Source	Total Paid
Medicare	$2.8M
Medicaid	$0

Key Findings

This provider’s Medicare activity is dominated by in-office biologic and infusion therapies consistent with Rheumatology specialty care: top drug codes include J0897, J9312, J0129, J3262, J1745 and J1602, and the claims mix also includes infusion/administration codes (96413, 96365, 96415, 96372). The presence of bone density imaging (77080) and labs for vitamin D, CMP, CRP, and TSH further supports a practice model that manages chronic inflammatory and bone-health conditions alongside frequent parenteral biologic delivery.

Revenue concentration is high and very focused: the precomputed top 3 Medicare codes account for 59.9% of this provider’s total Medicare revenue. Specifically, J0897 generated $798.1K (28.9%), J9312 generated $436.8K (15.8%), and J0129 generated $420.8K (15.2%), together forming the majority of the $2.8M in Medicare lifetime revenue.

Payer mix is effectively single-payer Medicare: lifetime Medicare revenue is $2.8M while there is no Medicaid billing on file. This indicates either non-participation in Medicaid or a Medicare-heavy patient panel, which has implications for network negotiations and care coordination strategies with payers that serve dual-eligible populations.

For certain codes the provider is a clear national outlier: J0897 ranks #31 of 10057 providers nationally (100th percentile; extreme outlier), and J9312 ranks #16 of 317 providers nationally (95th percentile; notably above typical national volume). By contrast, J0129 ranks #321 of 1221 providers nationally (74th percentile; typical, unremarkable volume), indicating the provider’s exceptional positioning is concentrated in specific biologic agents rather than across all biologics.

Evaluation & management volumes are unusually high for a specialist: 99214 generated 2.4K claims and $207.7K (7.5% of Medicare revenue) and ranks #589 of 479517 providers nationally (100th percentile; extreme outlier), while 99213 and 99205 also appear as high-percentile outliers. This pattern suggests heavy clinic throughput and a substantial number of complex office visits, consistent with ongoing management of chronic rheumatologic conditions.

Infusion and administration activity extends beyond single-dose injections: chemotherapy/infusion codes such as 96413 (362 claims, $34K, 1.2%) and 96415 (389 claims, $8.2K, 0.3%) are present along with high-volume administration code 96372 (1.4K claims, $14.1K, 0.5%). Several of these administration and add-on codes rank well above typical national volumes (96415 at the 97th percentile and 96372 at the 100th percentile; extreme or notably above typical volume), supporting the conclusion that the practice operates a sustained infusion/infusion-support service line.

Ancillary diagnostics and monitoring are offered on-site or tightly integrated with the practice: DXA (77080, 240 claims, $8.4K) and lab testing like 82306, 80053, 86140 and 84443 appear in the top codes, mostly with ranks in the typical-to-above-typical range. These services align with rheumatology case management needs such as bone-density surveillance and inflammatory marker monitoring, adding downstream revenue and clinical control of monitoring pathways.

The provider has long-standing Medicare enrollment and an established footprint: NPI enumerated 2006-10-19 (~20 years ago). Combined with $2.8M in lifetime Medicare revenue and multiple national outlier code ranks, the data support characterization of an established, Medicare-focused rheumatology practice with concentrated strength in specific biologic infusion therapies.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

77 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0897	Injection, denosumab, 1 mg	44,340	$20	$798.1K
J9312	Injection, rituximab, 10 mg	7,800	$60	$436.8K
J0129	Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	12,750	$30	$420.8K
J3262	Injection, tocilizumab, 1 mg	61,500	$10	$307.5K
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…	2,440	$90	$207.7K
J1602	Injection, golimumab, 1 mg, for intravenous use	17,780	$10	$177.8K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	5,540	$30	$144K
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…	940	$60	$55.6K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	360	$90	$34K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	230	$140	$32.5K

Showing 1–10 of 77

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 77 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Georgia Distribution

William Tidmore — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. state median

77 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	9	30	9,660	$30	$403.6K
J9312	2	10	4,620	$60	$307.4K
J1602	13	30	17,200	$10	$240.1K
J3262	4	10	45,840	$1	$233.4K
J1745	6	30	2,160	$30	$96.6K
J0897	2	290	2,460	$20	$90.2K
96413	36	160	170	$90	$20.3K
93306	780	810	180	$80	$17.9K
99214	13	13,640	120	$80	$17.8K
83970	37	130	40	$40	$15.2K

Showing 1–10 of 77

Related Providers

Other providers that share a Tax Identification Number (TIN) with William Tidmore, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Michael Yuz	FL	Diagnostic Radiology Physician	$410.4K	$92.4K
Valdosta Family Medicine Associates, P.C.	GA	Family Medicine Physician	$0	$375.4K
Leon Smith	GA	Family Medicine Physician	$370.4K	$0
Jessica White	GA	Internal Medicine Physician	$270.1K	$0
Robert Bennett	GA	Family Medicine Physician	$247.2K	$0
James Collins	AZ	Diagnostic Radiology Physician	$195.9K	$12K
Jennifer Lawrence	GA	Endocrinology, Diabetes & Metabolism Physician	$194.4K	$0
Craig Bishop	GA	Family Medicine Physician	$163.8K	$0
Aamer Farooki	PA	Diagnostic Radiology Physician	$71.8K	$8K
Steven Dileo	CO	Diagnostic Radiology Physician	$38.3K	$7.4K

Nearby Providers

Other providers in the same ZIP code as William Tidmore, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southern Home Care Services, Inc.	GA	Home Health Agency	$0	$212.2M
Southern Home Care Services, Inc.	GA	In Home Supportive Care Agency	$0	$42.9M
Behavioral Health Services Of South Georgia	GA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$30.1M
1st America Infusion Services LLC	GA	Home Infusion Therapy Pharmacy	$219.3K	$18.5M
Hospital Authority Of Valdosta And Lowndes County Georgia	GA	General Acute Care Hospital	$0	$14M
Choices For Life Of Georgia, LLC	GA	Community/Behavioral Health Agency	$0	$9M
Valdosta Children's Healthcare Center ,LLC	GA	Pediatric Adolescent Medicine Physician	$0	$6.5M
Southern Home Care Services, Inc.	GA	Home Health Agency	$0	$6.5M
Paula Bennett	GA	Nurse Practitioner	$0	$3.2M
Sgmp Southland LLC	GA	Psychiatry Physician	$0	$1.6M

William Tidmore — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References