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.

Memorial Drive Family Medicine P.C (NPI 1285994251)

Memorial Drive Family Medicine P.C is a family medicine physician provider located in Stone Mountain, Georgia. This profile covers 0 Medicare and 33 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	Memorial Drive Family Medicine P.C
Address	4958 Memorial Dr
City	Stone Mountain
State	GA
ZIP	30083
Taxonomy	Family Medicine Physician
NPI Enumerated	May 23, 2012

Payer Source	Total Paid
Medicaid	$522K
Medicare	$0

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

33 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…	6,570	$60	$361.4K
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…	2,480	$40	$101.7K
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…	300	$80	$24.9K
99050	In this procedure, the provider renders services to a patient in his office at a time when that office would otherwise be closed.	760	$20	$11.3K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	220	$30	$6.4K
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…	70	$70	$4.6K
81002	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dip stick, and shakes off the excess urine. Alternatively, the analyst may place drops of the urine specimen…	1,590	$1	$3.2K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	1,950	$1	$1.9K
87400	The lab analyst performs the technical lab test to detect antigens of influenza A or B using an immunoassay technique, such as EIA. This analysis will distinguish if a patient has influenza A or B.	100	$10	$1.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	20	$60	$860

Showing 1–10 of 33

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

Memorial Drive Family Medicine P.C — 0 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

33 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…	245	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…	97	820	390	$70	$245K
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.	239	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.	154	170	500	$100	$170.6K
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…	177	310	90	$90	$136.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	146	160	190	$110	$129.7K
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…	67	230	100	$110	$97.1K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	83	160	260	$30	$54.2K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	84	100	180	$40	$54.2K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	50	50	110	$20	$33.6K

Showing 1–10 of 33

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Edward M. Gotlieb, M.d., Et Al Dba The Pediatric Center	GA	Pediatrics Physician	$0	$5.6M
Rose Petal Falls, LLC	GA	Home Health Agency	$0	$4.6M
Metro Ambulance Services Inc	GA	Ambulance	$3.8M	$7.1K
Access Home Care, LLC	GA	In Home Supportive Care Agency	$0	$1.6M
Medcura Health, Inc.	GA	Federally Qualified Health Center (FQHC)	$0	$1.4M
Kevin Tucker	GA	Professional Counselor	$0	$842.9K
Stone Mountain Dialysis Center, LLC	GA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$450.9K
E Z Transportation LLC	GA	Non-emergency Medical Transport (VAN)	$411.2K	$0
Stone Mountain Immediate Medical Care, Inc.	GA	Health Maintenance Organization	$0	$263.7K
Lilian Mugwede	GA	Family Nurse Practitioner	$130.6K	$0

Memorial Drive Family Medicine P.C — Billing Profile & Reimbursement Data

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Memorial Drive Family Medicine P.C — 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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References