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.

Georgia Emergency Department Services, P.C. (NPI 1508886912)

Field	Value
Entity Type	Organization
Organization	Georgia Emergency Department Services, P.C.
Address	743 Spring St Ne
City	Gainesville
State	GA
ZIP	30501
Taxonomy	Emergency Medicine Physician
NPI Enumerated	July 20, 2006

Payer Source	Total Paid
Medicaid	$17.9M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and reports $17.9M in lifetime Medicaid revenue, making its Medicare-to-Medicaid mix effectively single‑payer with Medicaid as the dominant source of revenue. Analysts should treat Medicaid performance as representative of the provider's billed activity.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 97.5% of this provider's total Medicaid revenue, driven by 99285 (46.8%), 99284 (38.3%), and 99283 (12.3%). This narrow code mix indicates that a very small set of services produces almost all of the billed Medicaid dollars.

The code mix (99285, 99284, 99283) and the presence of critical care 99291 indicate an emergency department–centric operation with a substantial proportion of high- and moderate-acuity ED encounters. 99291 appears in the mix with 3.3K claims and $274.9K revenue (1.5% of Medicaid revenue), which supports the characterization of episodic, higher-intensity care being provided in addition to routine ED evaluation and management.

Competitive standing within Georgia is concentrated and unusually large for ED E/M codes: 99285 is an extreme outlier at #2 of 139 providers and the 99th percentile, and 99284 is also an extreme outlier at #3 of 231 providers and the 99th percentile. 99283 ranks #10 of 237 providers (96th percentile, notably above typical state volume), so the provider is a dominant in-state performer specifically for high- and moderate-acuity ED visits.

Ancillary and operational codes show high volume but limited revenue impact: 93010 has 30.1K claims for $120.2K revenue (0.7% of Medicaid revenue) and 93042 has 855 claims for $3.4K revenue while ranking #1 of 7 providers in-state (100th percentile). Overnight facility code 99053 shows 2K claims but $0 paid and ranks #4 of 48 (94th percentile), suggesting routine ED monitoring/24-hour presence is frequently billed to Medicaid at low or no unit payment.

The extreme concentration (97.5% from the top three codes) creates financial and contracting exposure: any policy or reimbursement change targeting ED E/M code valuation would disproportionately affect this provider's Medicaid revenue. Payers and analysts should flag the provider for focused rate-impact modeling tied to 99285/99284/99283.

The provider’s NPI was enumerated on 2006-07-20 (~20 years ago), indicating long tenure in the market; this duration is consistent with the high cumulative claim volumes reported for core ED services and may reflect established referral and patient flow patterns to this emergency department group.

While high-acuity ED codes dominate revenue, critical care add-ons beyond the initial time segment are limited in dollar impact: 99291 contributes $274.9K (1.5% of Medicaid revenue) and ranks #4 of 46 providers (93rd percentile, notably above typical state volume), implying most intensive services are captured within the high-level ED E/M codes (99285/99284) rather than prolonged critical care billing.

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
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.	92,300	$90	$8.4M
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.	88,170	$80	$6.9M
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.	44,950	$50	$2.2M
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…	3,310	$80	$274.9K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	30,050	$1	$120.2K
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…	220	$90	$20.6K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	140	$110	$14.9K
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…	40	$130	$5.8K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	150	$40	$5.5K
99217	N/A	180	$30	$4.9K

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

Georgia Emergency Department Services, P.C. — 4 of 15 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.	2	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.	3	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.	10	240	170	$120	$779.3K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	31	50	600	$90	$409.7K
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…	526	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…	711	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…	4	50	180	$220	$177.6K
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…	205	310	90	$90	$136.3K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	41	110	80	$70	$81.1K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	28	60	130	$40	$37.5K

Showing 1–10 of 17

Related Providers

Other providers that share a Tax Identification Number (TIN) with Georgia Emergency Department Services, P.C., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bradley Stearns	GA	Family Medicine Physician	$89.2K	$0
Sheba George	GA	Emergency Medicine Physician	$77.3K	$0
Amanda Pipkin	GA	Surgical Physician Assistant	$58.4K	$0
Jonathan Snyderman	ND	Emergency Medicine Physician	$44.5K	$0
Daniel Baquet	NC	Emergency Medicine Physician	$41.2K	$0
Hilliary Rounds	GA	Medical Physician Assistant	$28.1K	$0
Laura Reed	GA	Family Nurse Practitioner	$23.4K	$0
Camden Thurmond	GA	Physician Assistant	$16.7K	$0
Joshua Colliver	GA	Physician Assistant	$16.4K	$0
Jonathon Eck	NM	Emergency Medicine Physician	$15.3K	$0

Nearby Providers

Other providers in the same ZIP code as Georgia Emergency Department Services, P.C., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northeast Georgia Medical Center, Inc.	GA	General Acute Care Hospital	$0	$112.9M
S.y.a.h.	GA	Urgent Care Clinic/Center	$0	$6.5M
Pediatric Associates LLP	GA	Pediatrics Physician	$0	$5M
William Chafin	GA	Rheumatology Physician	$3.3M	$0
Marta Bognar	GA	Rheumatology Physician	$2.3M	$0
Brent Flickinger	GA	Rheumatology Physician	$2.3M	$0
Gainesville Radiology Group, PC	GA	Diagnostic Radiology Physician	$0	$2M
Hall County Georgia	GA	Land Ambulance	$1.6M	$0
Northeast Georgia Physicians Group Urgent Care LLC	GA	Family Medicine Physician	$0	$1.6M
Timothy Carey	GA	Medical Oncology Physician	$1.5M	$0

Georgia Emergency Department Services, P.C. — Billing Profile & Reimbursement Data

Sign up for Georgia Emergency Department Services, P.C. — Billing Profile & Reimbursement Data policy alerts

Georgia Emergency Department Services, P.C. — Billing Profile & Reimbursement Data

Sign up for Georgia Emergency Department Services, P.C. — Billing Profile & Reimbursement Data policy alerts

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