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.

Health Services Of Central Georgia, Inc (NPI 1184679482)

Key Findings

Field	Value
Entity Type	Organization
Organization	Health Services Of Central Georgia, Inc
Address	777 Hemlock St
City	Macon
State	GA
ZIP	31201
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	May 24, 2006

Payer Source	Total Paid
Medicaid	$18.5M
Medicare	$0

HEALTH SERVICES OF CENTRAL GEORGIA, INC is effectively a Medicaid-focused provider: there is no Medicare billing on file while total Medicaid revenue is $18.5M. The NPI was enumerated on 2006-05-24 (~20 years ago), indicating a long tenure in the market that aligns with the scale of the Medicaid activity reported.

Revenue is highly concentrated in office E/M visits: the precomputed top three Medicaid codes account for 41.3% of the provider's total Medicaid revenue. Those top three codes are 99213 ($2.9M, 18.9%), 99214 ($2.5M, 16.0%), and 99215 ($1M, 6.5%), signaling that a large share of income is driven by established-patient office visits across low, moderate, and high complexity levels.

The code mix indicates a multi-specialty, high-throughput ambulatory operation with significant primary care and longitudinal management activity: extremely high claim counts for 99213 (66.7K claims) and 99214 (38.7K claims) combined with substantial revenue from 99215 (10.6K claims) show routine, repeated outpatient encounters are a core service line. Preventive E/M codes such as 99391 (7.2K claims, $438.8K) and 99392 (5.5K claims, $379.2K) further support a strong preventive/well-care component alongside problem-based visits.

The provider also delivers substantial inpatient/observation and critical care services: 99232 appears with 22.2K claims and $688.4K revenue (97th percentile statewide) and 99222 (3K claims, $282.1K) ranks in the 99th percentile, while 99291 (2.8K claims, $195.3K) is in the 91st percentile. These volumes and high percentile ranks indicate the organization manages significant hospital/observation caseloads and some level of critical care, not just outpatient clinic work.

There is a meaningful obstetrics and prenatal imaging footprint: multiple ultrasound codes show notable volumes and revenue, for example 76811 (4.9K claims, $746.2K; rank #3 of 21, 90th percentile), 76819 (10K claims, $707.5K; rank #6 of 41, 88th percentile), 76816 (8.1K claims, $403.8K) and 76820 (5.4K claims, $375.7K). The spread across fetal anatomy, biophysical profile, reexamination, and Doppler studies signals a comprehensive prenatal imaging service line co-located with the clinic’s other outpatient offerings.

The provider offers allied/rehabilitation services alongside core medical care: 97530 (16.7K claims, $718.7K) and 97112 (8.1K claims, $308.8K) indicate substantial therapy activity, and 92507 (11K claims, $494.2K) shows speech/hearing services are also part of the mix. These services, together with high volumes of routine diagnostics like 93010 (71.5K claims, $285.9K; rank #4 of 101, 97th percentile), point to an integrated clinic model that captures downstream ancillary revenue.

State-level competitive standing is strong for several high-volume codes: 99215 ranks #1 of 164 providers in-state (100th percentile) and 99214 and 99213 rank in the 98th–99th percentiles, while diagnostic code 93010 is an extreme outlier at the 97th percentile with 71.5K claims. This pattern characterizes the entity as a major in-state provider for both higher-complexity office visits and selected high-throughput diagnostic services.

Operational profile implied by payment patterns favors high throughput with lower average paid-per-claim on many high-volume items: examples include 99213 at $44 avg paid/claim and 93010 at $4 avg paid/claim alongside very large claim volumes (66.7K and 71.5K claims respectively). That combination suggests a business model focused on volume-driven Medicaid care delivery rather than reliance on high-dollar per-claim reimbursements.

Medicaid: Complete Services Breakdown

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

212 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…	66,690	$40	$2.9M
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…	38,700	$60	$2.5M
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…	10,560	$100	$1M
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…	4,910	$150	$746.2K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	16,720	$40	$718.7K
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.	9,970	$70	$707.5K
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…	22,210	$30	$688.4K
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,…	20,350	$30	$610.6K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	10,980	$50	$494.2K
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…	7,190	$60	$438.8K

Showing 1–10 of 212

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

Health Services Of Central Georgia, Inc — 9 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

212 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.	89	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.	57	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.	53	240	170	$120	$779.3K
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	7	10	190	$370	$561.3K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	17	70	2,950	$60	$531.2K
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…	9	20	890	$60	$498.3K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	63	70	2,840	$30	$428.7K
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…	3	20	290	$180	$423.2K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	9	80	1,770	$60	$366K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	6	30	160	$500	$365K

Showing 1–10 of 212

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Imaging Subspecialists Of North Jersey, LLC	NJ	Diagnostic Radiology Physician	$0	$7.5M
Steven Allee	GA	Ophthalmology Physician	$1.7M	$0
Amjad Safvi	IL	Vascular & Interventional Radiology Physician	$568.9K	$765.4K
William Knopf	GA	Cardiovascular Disease Physician	$1.1M	$0
Carmine Oddis	GA	Cardiovascular Disease Physician	$814.4K	$0
Carter Tharpe	GA	Cardiovascular Disease Physician	$770.4K	$0
Amy Kingman	GA	Cardiovascular Disease Physician	$641.2K	$0
Wendell Ellis	GA	Cardiovascular Disease Physician	$583.3K	$0
Erik Schneibel	GA	Cardiovascular Disease Physician	$563.9K	$0
Julius Elmore	GA	Cardiovascular Disease Physician	$559.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Central Georgia Emergency Group, LLC	GA	Emergency Medicine Physician	$0	$8.8M
Middle Georgia Pediatrics	GA	Pediatric Adolescent Medicine Physician	$0	$4.2M
Linda Hendricks	GA	Specialist	$3.1M	$0
Mgas Holdings, LLC	GA	Ambulance	$2.5M	$36.9K
Marcus Weldon	GA	Hematology & Oncology Physician	$2.5M	$0
Cogent Healthcare Of Macon, LLC	GA	Internal Medicine Physician	$0	$1.8M
Central Georgia Pediatrics, Inc.	GA	Pediatric Adolescent Medicine Physician	$0	$1.6M
Alan Justice	GA	Internal Medicine Physician	$1.4M	$0
Central Georgia Pet LLC	GA	Radiation Oncology Physician	$1.4M	$0
Children's Neurology Ctr Macon, LLC	GA	Neurology with Special Qualifications in Child Neurology Physician	$0	$1.3M

Health Services Of Central Georgia, Inc — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References