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.

Southeast Medical, Inc. (NPI 1427081934)

Field	Value
Entity Type	Organization
Organization	Southeast Medical, Inc.
Address	75 N Main St Ste 229
City	Clayton
State	GA
ZIP	30525
Taxonomy	Durable Medical Equipment & Medical Supplies
NPI Enumerated	July 8, 2006

Payer Source	Total Paid
Medicaid	$9.3M
Medicare	$0

Key Findings

This provider is effectively a single-payer Medicaid supplier: there is no Medicare billing on file and total Medicaid revenue on record is $9.3M. The absence of Medicare activity indicates the business is focused on Medicaid populations or Medicaid-covered DME lines rather than Medicare-covered beneficiaries.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 75.3% of this provider's total Medicaid revenue. Those top three codes are A4353 ($5.1M, 54.7% of Medicaid revenue), A4351 ($1.4M, 15.3%), and A4352 ($491.7K, 5.3%), showing a narrow set of products driving the bulk of receipts.

The code mix points to a DME operation specialized in urinary catheter supplies and ostomy products. The dominance of catheter codes (A4353, A4351, A4352) combined with substantial ostomy-related lines such as A4409 ($396.9K) and A4385 ($316.4K) suggests the business model centers on high-volume consumable urology and ostomy supply distribution.

Several of the provider's leading codes show statewide dominance: the provider ranks #1 in-state for A4353, A4351, and A4352 and is at the 100th percentile for those codes, signaling it is a major statewide supplier for intermittent urinary catheters. Other items where it ranks at or near the top in-state include E1399 (rank #1 of 2) and multiple accessory items (many codes at the 75–100th percentile), underscoring competitive strength in its core product lines.

The data include explicit labels about relative volume: A4353 and A4351 are noted as "notably above typical state volume," while A4352 is described as "typical, unremarkable volume." This indicates that the provider's outsized Medicaid revenue is driven by a small number of codes where it substantially exceeds typical in-state supply volumes, rather than broad-based above-market performance across many codes.

Claim-level economics amplify the concentration effect: A4353 has 7.3K claims at $691 avg paid/claim (generating $5.1M), whereas A4351 has 10.2K claims at $138 avg paid/claim ($1.4M) and A4352 has 1K claims at $483 avg paid/claim ($491.7K). The high average paid amount on A4353 combined with substantial claim volume explains why that single code accounts for the majority share of Medicaid revenue.

The provider has long tenure on file — NPI enumerated 2006-07-08 (~20 years ago) — indicating an established presence in the state Medicaid DME market. Given sustained Medicaid revenue of $9.3M and the lack of Medicare billing, the entity appears to operate as a longstanding, Medicaid-focused DME/supplies specialist rather than a cross-payer national DME vendor.

Medicaid: Complete Services Breakdown

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

46 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
A4353	Intermittent urinary catheter, with insertion supplies	7,320	$690	$5.1M
A4351	Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each	10,220	$140	$1.4M
A4352	Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each	1,020	$480	$491.7K
A4409	Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each	5,290	$80	$396.9K
A4385	Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each	5,270	$60	$316.4K
A9270	Non-covered item or service	240	$790	$188.6K
A4407	Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each	2,020	$90	$181.6K
E1399	Durable medical equipment, miscellaneous	220	$810	$178.7K
A4554	Disposable underpads, all sizes	5,070	$30	$162.3K
A4425	Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each	3,300	$40	$138.6K

Showing 1–10 of 46

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

Southeast Medical, Inc. — 11 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

46 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A4353	Intermittent urinary catheter, with insertion supplies	1	10	2,830	$540	$1.8M
A4351	Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each	1	10	4,770	$130	$581.1K
A4554	Disposable underpads, all sizes	2	10	1,250	$50	$249.2K
A4385	Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each	2	10	3,020	$50	$234.5K
A4352	Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each	1	10	550	$400	$213.5K
A4407	Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each	2	10	2,020	$70	$190.8K
A4409	Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each	2	10	780	$60	$146.5K
T4535	Disposable liner/shield/guard/pad/undergarment, for incontinence, each	3	10	790	$30	$99.3K
A4425	Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each	2	10	450	$40	$91.8K
E1399	Durable medical equipment, miscellaneous	1	10	130	$680	$89.4K

Showing 1–10 of 46

Nearby Providers

Other providers in the same ZIP code as Southeast Medical, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Timothy Beck	GA	Internal Medicine Physician	$471.6K	$0
Rabun County Board Of Commissioners	GA	Land Ambulance	$406.7K	$0
Brian Pratt	GA	Family Medicine Physician	$205.9K	$0
Robert Berger	GA	Diagnostic Radiology Physician	$137K	$0
Donald Nichols	GA	Podiatrist	$81.3K	$0
Pamila Mcintyre	GA	Nurse Practitioner	$65.9K	$0
Brian Jamail	GA	Physician Assistant	$41.1K	$0

Southeast Medical, Inc. — Billing Profile & Reimbursement Data

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Southeast Medical, 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

Nearby Providers

Frequently Asked Questions

References