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.

Atlanta Perinatal Associates (NPI 1104973064)

Key Findings

Field	Value
Entity Type	Organization
Organization	Atlanta Perinatal Associates
Address	550 Peachtree St Ne Ste 1275
City	Atlanta
State	GA
ZIP	30308
Taxonomy	Maternal & Fetal Medicine Physician
NPI Enumerated	January 4, 2007

Payer Source	Total Paid
Medicaid	$38.3M
Medicare	$0

This provider is effectively single‑payer in the available claims data: Medicare billing is none on file while Medicaid accounts for $38.3M in lifetime revenue. That asymmetric payer mix means operational and revenue exposure is concentrated in Medicaid policy and contracting rather than Medicare reimbursement dynamics.

Revenue is concentrated in a small set of services: the precomputed top 3 Medicaid codes by revenue account for 43.7% of this provider’s total Medicaid revenue. Specifically, 99213 generates $6M (15.8%), 76819 generates $5.6M (14.7%), and 76811 generates $5.1M (13.3%), showing a heavy dependence on a few high‑volume E/M and obstetric imaging codes.

The code mix and descriptions identify ATLANTA PERINATAL ASSOCIATES as a high‑volume maternal–fetal medicine and obstetric imaging operation: dominant codes include biophysical profile (76819), anatomical/transabdominal fetal ultrasound (76811), and standard E/M visits for established patients (99213). These services indicate routine prenatal surveillance, repeated ultrasound assessments, and large clinic throughput rather than general primary care or non‑obstetric specialties.

Competitive standing in Georgia is unusually strong for specialized fetal imaging and surveillance. Multiple imaging codes rank #1 in‑state at the 100th percentile and are labeled “extreme outlier” or similar (for example, 76819 is #1 of 41 providers in‑state (100th percentile; extreme outlier), 76811 is #1 of 21 (100th percentile; extreme outlier), and 76816 is #1 of 55 (100th percentile; extreme outlier)), implying this provider is a dominant statewide provider for these procedures.

High outpatient evaluation-and-management volume supports the interpretation of a busy prenatal clinic model: 99213 alone accounts for $6M and ranks #6 of 917 providers in‑state (99th percentile; extreme outlier, far above typical state volume for this code). Complementary E/M codes (99214, 99212) also appear in the top code list at unremarkable to high state percentiles, indicating substantial routine follow‑up and visit throughput alongside imaging.

The practice offers advanced fetal surveillance services beyond routine ultrasound, evidenced by strong statewide rankings for Doppler and fetal cardiac studies. Codes such as 76825 (real‑time fetal echocardiography, $1.2M, #1 of 12 in‑state (100th percentile; extreme outlier)) and Doppler codes 76820/76821 (each ranked #1 in‑state and labeled 100th percentile; extreme outlier or notably above typical state volume) point to an ability to manage high‑risk pregnancies and complex fetal assessments.

The NPI tenure (enumerated 2007-01-04 (~19 years ago)) combined with the concentrated Medicaid revenue and code dominance suggests an established specialty referral center serving Georgia’s Medicaid population. That longevity plus code‑level leadership implies durable referral relationships and operational scale in perinatal services.

Because a large share of revenue is tied to a handful of imaging and E/M codes (top 3 = 43.7%), the provider’s revenue profile is sensitive to changes in utilization or Medicaid reimbursement for those specific codes. From a payer or network planning perspective, monitoring utilization trends and policy changes for 99213, 76819, and 76811 will be important to assess near‑term revenue and capacity impacts.

Medicaid: Complete Services Breakdown

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

34 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…	102,400	$60	$6M
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	64,550	$90	$5.6M
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	23,950	$210	$5.1M
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	76,760	$60	$4.9M
76818	The provider performs a biophysical profile test to measure the health of the baby during pregnancy. The test consists of a nonstress test and an ultrasound.	32,290	$90	$2.9M
76821	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the middle cerebral artery. This test determines the timing of labor induction and…	14,140	$90	$1.3M
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…	15,060	$90	$1.3M
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	15,040	$80	$1.3M
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	10,940	$120	$1.3M
76817	The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.	15,100	$80	$1.3M

Showing 1–10 of 34

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

Atlanta Perinatal Associates — 18 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. Georgia median

34 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
93325	The provider performs Doppler echocardiography, a diagnostic procedure based on the Doppler effect of sound, color flow velocity mapping, a two–dimensional image representation of blood flow in the…	4	20	890	$60	$498.3K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	1	20	290	$180	$423.2K
76821	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the middle cerebral artery. This test determines the timing of labor induction and…	1	10	1,730	$80	$375.3K
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…	6	920	370	$60	$360.6K
76825	The provider performs real–time fetal echocardiography, with or without M–mode recording, for complete evaluation of a fetal cardiovascular system.	1	10	730	$240	$348.7K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	1	40	220	$70	$299.7K
76818	The provider performs a biophysical profile test to measure the health of the baby during pregnancy. The test consists of a nonstress test and an ultrasound.	1	20	420	$80	$255K
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…	47	820	390	$70	$245K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	28	30	90	$160	$236.3K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	1	60	550	$50	$193.7K

Showing 1–10 of 34

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dva Renal Healthcare Inc	GA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$972.5K
Sagar Patel	GA	Radiation Oncology Physician	$955.9K	$0
Nikhil Sebastian	GA	Radiation Oncology Physician	$730.9K	$0
Soumon Rudra	GA	Radiation Oncology Physician	$622.7K	$0
Mark Mcdonald	GA	Radiation Oncology Physician	$565K	$0
William Stokes	GA	Radiation Oncology Physician	$433.8K	$0
Midtown Endoscopy Center, LLC	GA	Endoscopy Clinic/Center	$374.7K	$0
David Delurgio	GA	Clinical Cardiac Electrophysiology Physician	$297.6K	$0
Professional Therapy Providers, Inc	GA	Speech-Language Pathologist	$0	$284K
Evan Schoenberg	GA	Ophthalmology Physician	$275.1K	$0

Atlanta Perinatal Associates — Billing Profile & Reimbursement Data

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Atlanta Perinatal Associates — 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