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.

Etowah Emergency Physicians, LLC (NPI 1306388343)

Key Findings

Field	Value
Entity Type	Organization
Organization	Etowah Emergency Physicians, LLC
Address	2360 Rockmart Hwy
City	Cedartown
State	GA
ZIP	30125
Taxonomy	Emergency Medicine Physician
NPI Enumerated	November 8, 2016

Payer Source	Total Paid
Medicaid	$10.7M
Medicare	$0

This provider has no Medicare billing on file and is effectively single-payer with respect to federal programs: total Medicaid revenue is $10.7M and there is no recorded Medicare revenue. That concentration means reimbursement and volume trends in Medicaid will largely determine the practice’s top-line fiscal performance.

Revenue is highly concentrated in three emergency department E/M codes: the top 3 Medicaid codes account for 97.9% of the provider’s total Medicaid revenue. Specifically, 99284 generated $4.6M (42.9%), 99285 generated $4.3M (40.4%), and 99283 generated $1.6M (14.7%), indicating the business is overwhelmingly driven by ED visit billing.

The code mix and volumes point to an ED-focused service model that manages a large number of moderate- and high-acuity emergency visits. 99284 shows 58.3K claims at $79 avg paid/claim and 99285 shows 45.2K claims at $96 avg paid/claim; these high counts and the predominance of mid- and high-level E/M codes are consistent with an emergency-physician group that staffs high-volume ED care.

Competitive standing for high-acuity ED services is strong in-state: 99284 ranks #8 of 231 providers in-state (97th percentile; extreme outlier, far above typical state volume for this code) and 99285 ranks #7 of 139 providers in-state (96th percentile; notably above typical state volume for this code). These rankings indicate the provider is a major volume player for moderate- and high-complexity ED visits within Georgia.

Lower-acuity E/M and outpatient codes are present but represent small shares of revenue and volume relative to core ED work. 99283 accounts for $1.6M revenue with 32.8K claims and ranks #14 of 237 providers in-state (94th percentile; typical, unremarkable volume for this code), and office E/M codes such as 99213 and 99214 together represent only about 1.6% of Medicaid revenue, suggesting ancillary outpatient work is secondary to ED operations.

Critical care and advanced services are present but immaterial to total revenue: 99291 appears 182 times producing $15.5K (0.1% of Medicaid revenue) and ranks #23 of 46 providers in-state (51th percentile; typical, unremarkable volume for this code). This suggests some provision of critical care services, but not at a scale that meaningfully diversifies revenue away from ED evaluation-and-management visits.

Point-of-care and lab testing are routine but low-revenue add-ons to the ED workflow, with codes like 87804 (478 claims, $12K), 87880 (737 claims, $10.3K), and 87426 (270 claims, $9.2K) recorded. These items support an ED clinical footprint that performs common infectious disease diagnostics at the point of care, but they do not materially change the provider’s revenue profile which is dominated by E/M codes.

The provider’s NPI was enumerated 2016-11-08 (~10 years ago), indicating it is an established entity in the market. Combined with the heavy Medicaid dependence and the extreme/high statewide rankings on 99284 and 99285, the profile implies both operational strength in ED throughput and a concentration risk tied to Medicaid reimbursement and policy changes.

Medicaid: Complete Services Breakdown

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	58,320	$80	$4.6M
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.	45,190	$100	$4.3M
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.	32,810	$50	$1.6M
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…	1,810	$60	$102.9K
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…	760	$90	$69.2K
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…	180	$90	$15.5K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	480	$30	$11.9K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	740	$10	$10.3K
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,…	270	$30	$9.2K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	160	$20	$3.8K

Showing 1–10 of 17

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

Etowah Emergency Physicians, LLC — 2 of 14 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

17 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.	7	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.	8	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.	14	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…	276	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…	331	820	390	$70	$245K
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…	23	50	180	$220	$177.6K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	25	40	200	$20	$72.2K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	124	130	480	$20	$59.9K
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,…	79	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…	77	100	180	$40	$54.2K

Showing 1–10 of 17

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kisa Seymore	GA	Dermatology Physician	$405.8K	$0
Pulin Patel	GA	Family Medicine Physician	$97.9K	$0
Karen Eberhart	GA	Family Medicine Physician	$85.5K	$0

Etowah Emergency Physicians, LLC — Billing Profile & Reimbursement Data

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Etowah Emergency Physicians, LLC — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cline Jackson	GA	Emergency Medicine Physician	$116.9K	$0
John Hardwell	GA	Emergency Medicine Physician	$104.9K	$0