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 Alabama for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Alabama 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. Alabama (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.

Athens-limestone Er Physicians (NPI 1528314119)

Field	Value
Entity Type	Organization
Organization	Athens-limestone Er Physicians
Address	700 W Market St
City	Athens
State	AL
ZIP	35611
Taxonomy	Emergency Medicine Physician
NPI Enumerated	August 1, 2012

Payer Source	Total Paid
Medicaid	$1.7M
Medicare	$0

Medicaid: Complete Services Breakdown

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

7 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.	17,570	$50	$913.7K
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.	16,420	$40	$705.9K
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.	3,530	$30	$116.3K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	3,010	$1	$9K
99401	At an encounter separate from a preventive medicine visit, the provider offers counseling related to subjects appropriate for the patient’s age, family history, and areas of concern. The subjects…	20	$0	$0
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	150	$0	$0
G9744	Patient not eligible due to active diagnosis of hypertension	90	$0	$0

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Alabama providers billing the same CPT/HCPCS codes.

Claims Volume vs. Alabama Distribution

Athens-limestone Er Physicians — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. Alabama median

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	53	240	4,820	$60	$807.6K
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.	16	190	1,480	$100	$730.7K
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.	137	230	5,160	$40	$474.1K
99401	At an encounter separate from a preventive medicine visit, the provider offers counseling related to subjects appropriate for the patient’s age, family history, and areas of concern. The subjects…	118	120	770	$10	$27.4K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	52	170	890	$10	$25.2K
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	137	240	230	$0	$0
G9744	Patient not eligible due to active diagnosis of hypertension	21	30	260	$0	$0

Related Providers

Other providers that share a Tax Identification Number (TIN) with Athens-limestone Er Physicians, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wayne Jones	AL	Emergency Medicine Physician	$105.8K	$0
Brandi Ray	AL	Adult Health Nurse Practitioner	$96.5K	$0
Kenneth Collins	AL	Emergency Medicine Physician	$93.1K	$0
Robert Flowers	AL	Internal Medicine Physician	$71.7K	$0
Jennifer Grutzik	AL	Physician Assistant	$58.4K	$0

Nearby Providers

Other providers in the same ZIP code as Athens-limestone Er Physicians, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Advantage Dental Oral Health And Vision Center Of Alabama, P.C.	AL	Pediatric Dentistry	$0	$6.3M
Central Pediatrics Inc.	AL	Preferred Provider Organization	$0	$4.1M
Hh Health System - Athens Limestone, LLC	AL	General Acute Care Hospital	$0	$2.7M
Athens Limestone Health Services, LLC	AL	Ambulance	$1M	$1.2M
Pathways Speech Therapy, Inc.	AL	Speech-Language Pathologist	$0	$985.9K
Limestone County Health Dept Fp Clinic	AL	Public Health or Welfare Agency	$0	$936.3K
R Hill	AL	Specialist	$333.6K	$0
Cassidy Koonce	AL	Surgery Physician	$281K	$0
Nauman Qureshi	AL	Specialist	$263K	$0
Crystal Walker	AL	Cardiovascular Disease Physician	$194.6K	$0

Athens-limestone Er Physicians — Billing Profile & Reimbursement Data

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Athens-limestone Er Physicians — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References