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.

Grady Memorial Hospital Corporation (NPI 1114243813)

Grady Memorial Hospital Corporation is a family medicine physician provider located in Atlanta, Georgia. This profile covers 0 Medicare and 116 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Grady Memorial Hospital Corporation
Address	80 Jesse Hill Jr Dr Se
City	Atlanta
State	GA
ZIP	30303
Taxonomy	Family Medicine Physician
NPI Enumerated	April 20, 2010

Payer Source	Total Paid
Medicaid	$5.9M
Medicare	$0

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

116 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…	53,700	$40	$1.9M
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…	34,080	$30	$1.1M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	9,000	$70	$602.7K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	17,660	$30	$600.3K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	6,980	$70	$488.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	11,790	$30	$306.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2,890	$80	$225.5K
99215	The provider sees an established 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…	1,880	$60	$111K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1,280	$80	$107.2K
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…	2,950	$30	$100.2K

Showing 1–10 of 116

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

Grady Memorial Hospital Corporation — 5 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

116 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	135	140	200	$280	$1.9M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	60	230	120	$170	$937.5K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	67	240	170	$120	$779.3K
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…	35	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…	12	820	390	$70	$245K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	18	180	680	$90	$226.7K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	10	180	720	$90	$204.2K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	22	50	180	$220	$177.6K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	14	250	660	$40	$172.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	35	170	500	$100	$170.6K

Showing 1–10 of 116

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Emory Medical Care Foundation Inc	GA	Internal Medicine Physician	$0	$41.4M
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Frank Curvin	GA	Family Medicine Physician	$10.6M	$0
Grady Ems LLC	GA	Land Ambulance	$6M	$66.8K
Children's Healthcare Of Atlanta At Hughes Spalding	GA	Children's Hospital	$0	$5.2M
Grady Memorial Hospital Corporation	GA	General Acute Care Hospital	$0	$1.7M
Mark Chastain	GA	Dermatology Physician	$1.6M	$0
Ephraim Parent	FL	Nuclear Medicine Physician	$1.5M	$0
Sagar Patel	GA	Radiation Oncology Physician	$955.9K	$0
Vishal Dhere	CO	Radiation Oncology Physician	$771.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ace Care Management LLC	GA	Case Management Agency	$0	$16.5M
Walker Family Services LLC	GA	Community/Behavioral Health Agency	$0	$1.2M
Emerginet, LLC	GA	Emergency Medical Services (Emergency Medicine) Physician	$0	$790.7K
Ronak Shah	GA	Diagnostic Radiology Physician	$710.2K	$0
Emerginet Henry, LLC	GA	Emergency Medical Services (Emergency Medicine) Physician	$0	$413.4K
Time Organization, Inc.	GA	Psychiatry Physician	$0	$283.8K
April Farley	GA	Diagnostic Radiology Physician	$243.5K	$550
Sam Sheikali	GA	Emergency Medicine Physician	$52.1K	$144.9K
Frank Mihlon	GA	Diagnostic Radiology Physician	$175.9K	$0
Emerginet Srmc, LLC	GA	Emergency Medical Services (Emergency Medicine) Physician	$0	$168K

Grady Memorial Hospital Corporation — Billing Profile & Reimbursement Data

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Grady Memorial Hospital Corporation — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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