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.

Piedmont Providers LLC (NPI 1548273592)

Piedmont Providers LLC is a internal medicine physician provider located in Jasper, Georgia. This profile covers 0 Medicare and 96 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	Piedmont Providers LLC
Address	220 J L White Dr Ste 120
City	Jasper
State	GA
ZIP	30143
Taxonomy	Internal Medicine Physician
NPI Enumerated	August 14, 2006

Payer Source	Total Paid
Medicaid	$1.6M
Medicare	$0

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

96 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…	19,290	$40	$810.3K
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…	10,820	$40	$378.7K
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…	1,870	$60	$106.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	1,630	$50	$76.8K
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…	770	$80	$58.1K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	710	$30	$18.5K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	1,740	$10	$12.2K
20611	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa, typically the shoulder, hip, knee, or subacromial bursa, and then uses the syringe…	220	$50	$11.9K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	10,100	$1	$10.1K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	340	$30	$9.9K

Showing 1–10 of 96

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

Piedmont Providers LLC — 1 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

96 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	16	30	160	$500	$365K
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…	101	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…	36	820	390	$70	$245K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	32	60	550	$50	$193.7K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	184	360	370	$50	$153.6K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	99	160	230	$30	$141.4K
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…	38	310	90	$90	$136.3K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	77	120	590	$20	$118.3K
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…	40	230	100	$110	$97.1K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	122	190	310	$30	$92K

Showing 1–10 of 96

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Piedmont Healthcare, P.A.	NC	Internal Medicine Physician	$0	$34.1M
Piedmont Medical Care Corporation	GA	Internal Medicine Physician	$0	$3.8M
Dijana Christianson	NC	Internal Medicine Physician	$1.5M	$0
Sean Fahey	NC	Rheumatology Physician	$1.2M	$0
Craig Dubois	NC	Neurology Physician	$821.1K	$0
Frank Lichtenberger	NC	Allergy & Immunology Physician	$653.5K	$0
Ronald Terry	GA	Radiation Oncology Physician	$600.6K	$0
Brion Lock	GA	Pulmonary Disease Physician	$552.6K	$0
Piedmont Healthcare, PA	NC	Endoscopy Clinic/Center	$353K	$162.4K
Duncan Mccall	NC	Rheumatology Physician	$478.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Khawaja Mahmood	GA	Pediatric Adolescent Medicine Physician	$0	$2.1M
Matthew Camp	GA	Ophthalmology Physician	$1.2M	$0
North Georgia Primary Care PC	GA	Internal Medicine Physician	$0	$950.9K
George Mackel, Pmhnp-bc, LLC	GA	Psychiatric/Mental Health Nurse Practitioner	$0	$765.1K
Jasper Surgery Center LLC	GA	Ambulatory Surgical Clinic/Center	$677.5K	$0
Ghada Kunter	GA	Hematology & Oncology Physician	$607.5K	$0
Pickens County Government	GA	Land Ambulance	$373.3K	$0
Carlton Faulk	GA	Dermatology Physician	$363.5K	$0
John Schnars	GA	Orthopaedic Surgery Physician	$329.5K	$0
Scott Masson	GA	Interventional Pain Medicine Physician	$297.2K	$0

Piedmont Providers LLC — Billing Profile & Reimbursement Data

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Piedmont Providers LLC — 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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