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.

Grace Medical Clinic (NPI 1093887168)

Field	Value
Entity Type	Organization
Organization	Grace Medical Clinic
Address	230 W College St
City	Griffin
State	GA
ZIP	30224
Taxonomy	Internal Medicine Physician
NPI Enumerated	November 14, 2006

Payer Source	Total Paid
Medicaid	$275.4K
Medicare	$0

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	4,300	$50	$201.9K
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…	2,200	$30	$72.4K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	30	$30	$730
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	10	$30	$360
99497	The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…	20	$0	$0
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	280	$0	$0
G0444	Annual depression screening, 5 to 15 minutes	150	$0	$0

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

Grace Medical Clinic — 0 of 4 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

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	263	920	370	$60	$360.6K
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…	130	820	390	$70	$245K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	173	190	310	$30	$92K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	82	90	90	$60	$41.4K
99497	The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…	14	20	70	$1	$1.3K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	5	20	60	$1	$80
G0444	Annual depression screening, 5 to 15 minutes	12	30	110	$1	$60

Nearby Providers

Other providers in the same ZIP code as Grace Medical Clinic, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Coker Pediatrics LLC	GA	Pediatrics Physician	$0	$9.5M
Georgia Emergency Group, LLC	GA	Emergency Medicine Physician	$0	$6.3M
Sunnyside Pediatrics	GA	Pediatrics Physician	$0	$5.4M
Leiv Takle	GA	Ophthalmology Physician	$328.3K	$0
Georgia Hospitalists Group, LLC	GA	Hospitalist Physician	$0	$299.1K
Aaron Roquemore	GA	Professional Counselor	$0	$291K
Hari Madichetty	GA	Specialist	$187.3K	$0
Mark Henson	GA	Foot & Ankle Surgery Podiatrist	$148.5K	$0
Joan Johnson	GA	Gerontology Nurse Practitioner	$112.7K	$0
John Dupre	GA	Pulmonary Disease Physician	$107K	$0

Grace Medical Clinic — Billing Profile & Reimbursement Data

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Grace Medical Clinic — 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