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 Alabama for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Alabama 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. Alabama (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.

The Orthopaedic Group, PC (NPI 1164489951)

The Orthopaedic Group, PC is a specialist provider located in Mobile, Alabama. This profile covers 0 Medicare and 24 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	The Orthopaedic Group, PC
Address	6144 Airport Blvd
City	Mobile
State	AL
ZIP	36608
Taxonomy	Specialist
NPI Enumerated	April 27, 2006

Payer Source	Total Paid
Medicaid	$1.4M
Medicare	$0

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

24 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…	10,020	$30	$340.6K
99203	The provider sees a new 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 provider…	4,850	$60	$300.4K
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…	4,760	$60	$295.2K
99204	The provider sees a new 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 provider…	2,520	$90	$221.6K
73110	The provider takes at least three X–ray images of a patient’s complete wrist to check for any fracture, swelling, or reason of pain in the wrist area.	1,520	$30	$47K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	1,240	$30	$40.8K
73630	In this diagnostic procedure, the provider takes a minimum of three views of the foot to assess injury, fracture, arthritis, tumor, or congenital abnormality.	1,490	$20	$35.7K
73562	In this procedure, the provider takes three X–ray images of a patient’s knee joint to check for any fracture, swelling, or reason for pain in the knee area.	830	$30	$26.6K
72170	In this procedure, the provider takes one or two X–ray images of the pelvic bone to check for any fracture, swelling, or reason of pain in the pelvis.	1,010	$20	$20.3K
73610	In this procedure, the provider takes three or more X–ray images of the ankle joint to check for any fracture, swelling, or reason for pain in the ankle area.	580	$30	$17.9K

Showing 1–10 of 24

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Alabama providers billing the same CPT/HCPCS codes.

Claims Volume vs. Alabama Distribution

The Orthopaedic Group, PC — 5 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. Alabama median

24 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	330	1,990	680	$60	$201.7K
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…	214	1,990	560	$40	$185.6K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	274	320	670	$20	$69.3K
99204	The provider sees a new 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 provider…	14	630	60	$80	$45.8K
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,…	359	500	120	$60	$42.2K
72082	In this diagnostic procedure, the provider takes X–ray images from two or three projections (directions or angles) of the entire thoracic (upper and middle) and lumbar (lower) spine to evaluate the…	4	10	700	$20	$28.2K
99203	The provider sees a new 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 provider…	10	660	80	$50	$26.8K
L4387	Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf	7	10	60	$50	$16.6K
73090	In this procedure, the provider takes two X–ray views of a patient’s forearm to check for any fracture, swelling, or reason of pain in the forearm area.	6	10	120	$10	$14.2K
L3908	Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf	13	20	100	$20	$12.3K

Showing 1–10 of 24

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vanna Eslava	AL	Family Nurse Practitioner	$391.6K	$0
Michael Blackmer	AL	Adult Reconstructive Orthopaedic Surgery Physician	$239K	$0
Robert Baird	AL	Orthopaedic Surgery Physician	$200.3K	$0
Charles Wilson	AL	Sports Medicine (Orthopaedic Surgery) Physician	$199.7K	$0
Michael Eslava	AL	Sports Medicine (Orthopaedic Surgery) Physician	$191.1K	$0
James Spain	AL	Sports Medicine (Family Medicine) Physician	$176.4K	$0
Matthew Barber	AL	Orthopaedic Surgery Physician	$168.8K	$0
James West	AL	Orthopaedic Surgery of the Spine Physician	$165.9K	$0
Jacob Kidder	AL	Orthopaedic Surgery Physician	$151.3K	$0
Timothy Frerichs	AL	Orthopaedic Surgery Physician	$142.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Medical Group, P.A.	AL	Specialist	$0	$7.4M
Coast Diagnostics, LLC	AL	Clinical Medical Laboratory	$275.1K	$5.7M
Springhill Hospitals, Inc	AL	General Acute Care Hospital	$0	$5.3M
Pulmonary Associates Of Mobile PC	AL	Pulmonary Disease Physician	$0	$5.3M
Providence Hospital	AL	General Acute Care Hospital	$0	$4.8M
Alabama Providence Healthcare Services	AL	Internal Medicine Physician	$0	$4.7M
University Of South Alabama Health Care Authority	AL	Internal Medicine Physician	$0	$3.9M
Mobile Emergency Physicians, LLC	AL	Emergency Medicine Physician	$0	$3.3M
Imc-pediatric & Adolescent Medicine, LLC	AL	Pediatric Adolescent Medicine Physician	$0	$3.3M
Springhill Emergency Physicians, PC	AL	Emergency Medicine Physician	$0	$3.2M

The Orthopaedic Group, PC — Billing Profile & Reimbursement Data

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The Orthopaedic Group, PC — 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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